Arthroscopic Stabilization for Shoulder Instability

What causes shoulder instability?

The articulation of the head of the humerus (upper arm bone) into the glenoid socket of the scapula (shoulder blade) forms the glenohumeral joint, one of three main joints in the shoulder. This joint is surrounded by ligaments that are primarily responsible for maintaining the position of the humeral head. However, these ligaments are unable to provide the necessary stability for the wide range of motion that the ball-and-socket configuration allows this joint. This lack of stability can result in easy separation of the humeral head away from the glenoid socket. A shoulder dislocation often tears the surrounding ligaments that may lead to shoulder instability and recurrent shoulder dislocations. Dr. Joseph D. Lamplot, orthopedic shoulder doctor, treats patients in Arlington Heights, Kildeer, Lake Zurich, Barrington, and the surrounding Northwest Suburbs of Chicago, IL, who have experienced a shoulder dislocation or multiple dislocations and are in need of surgical repair.

What is arthroscopic stabilization for shoulder instability?

Dr. Lamplot favors the arthroscopic technique for stabilizing the glenohumeral joint. This minimally invasive surgical procedure uses an arthroscope (small camera) to meticulously analyze the tissue structures of the glenohumeral joint. Specialized surgical instruments are then employed to stabilize the torn ligaments. The healthy ligament tissue is attached to the glenoid socket of the scapula with special surgical anchors that are secured within the bone. These surgical anchors return the glenohumeral joint back to its native anatomical position and minimize the risk of recurrence.

Some particular instances may require open surgery to stabilize the shoulder joint. This surgical approach involves a slightly larger incision that enables Dr. Lamplot to visualize the fix additional structures when a more extensive repair is needed. Open surgery may be recommended over an arthroscopic repair for patients with bone loss as a result of multiple shoulder dislocations, when the joint was not reduced successfully, or for patients with chronic shoulder instability.

What is a capsular shift?

Dr. Lamplot may also implement a capsular shift as an additional measure for stabilizing the shoulder joint. This open surgical procedure involves carefully incising the subscapularis muscle portion of the rotator cuff to gain access to the shoulder capsule. The joint capsule is then opened and the sections are overlapped by pulling up the bottom portion over the top portion which is simultaneously pulled down. These overlapping tissues are sutured together to diminish the overall volume of the shoulder joint capsule and improve stability of the joint.

What is a distal tibia allograft for glenoid bone loss?

Shoulder instability can also lead to glenoid bone loss, which can cause even more shoulder dislocations. By using an MRI or CT scan, Dr. Lamplot can determine if a tibia allograft will be needed to reconstruct the glenoid if bone loss has occurred. A distal tibia allograft uses donor tissue obtained from the distal (bottom) portion of the tibia (shin bone). The tissue (bone graft) is inserted into the section of the glenoid showing bone loss and secured to allow the graft to heal as part of the newly-reconstructed glenoid. A tibia allograft can be done as an open procedure. Dr. Lamplot can determine if the Latarjet procedure or a distal tibia allograft would be best for your specific shoulder instability depending on your preoperative imaging.

What is the recovery period like after arthroscopic stabilization for shoulder instability?

Following successful arthroscopic stabilization for shoulder instability, the recovery period is predominantly determined by the specific surgical procedure performed by Dr. Lamplot. Most patients in Arlington Heights, Kildeer, Lake Zurich, Barrington, and the surrounding Northwest Suburbs of Chicago, IL can anticipate a return to their normal daily activities in approximately 5-6 months, with a year or more of continued improvement. In general, the following can be expected during the recovery process:

• A sling or other device will be applied to the shoulder immediately after surgery to immobilize the joint. This immobilization device will remain in place for approximately 3 weeks.
• It is normal to experience post-operative pain, bruising, swelling, and general discomfort. These symptoms can be managed with rest, consistent ice application, and non-steroidal anti-inflammatory medications (NSAIDs).
• A physical rehabilitation program will be tailored to the patient’s specific needs and the timing of this program will be determined by Dr. Lamplot’s intra-operative findings. The key to a successful recovery following arthroscopic shoulder stabilization is adhering to and completing the prescribed physical therapy program.