Shoulder instability occurs when the ball of the shoulder joint slips partly or fully out of its socket, and is commonly seen in contact sports, overhead athletes and after traumatic dislocations. Surgical options range from arthroscopic Bankart repair to the Latarjet procedure for more complex or recurrent instability.
What Causes Shoulder Instability?
Most cases follow a traumatic dislocation during contact sport, a fall, or a collision, when the humeral head is forced out of the glenoid socket, often tearing the labrum (a Bankart lesion) and sometimes causing bone loss on the socket or humeral head. Repeated dislocations increase the risk of further instability and bone loss over time, particularly in young, active patients and contact/collision athletes.
Symptoms of Shoulder Instability
- A sensation of the shoulder “popping out” or slipping
- Recurrent dislocations or subluxations with progressively less force
- Pain, apprehension or weakness with overhead or throwing movements
- A feeling of instability during sport or daily activities
Diagnosis
Diagnosis is based on a history of dislocation or instability episodes, clinical examination of shoulder stability and apprehension, and imaging with X-rays and MRI or CT to assess the labrum, capsule and any bone loss on the glenoid (socket) or humeral head, which is critical in planning the most appropriate surgery.
Treatment: Bankart Repair and the Latarjet Procedure
Treatment is tailored to the pattern of instability, the amount of bone loss, and the patient’s sport and activity level. Arthroscopic Bankart repair, which reattaches the torn labrum and capsule to the glenoid, is often suitable for first-time or early instability with minimal bone loss. Where there is significant glenoid bone loss, recurrent instability, or a high risk of failure with soft-tissue repair alone, such as in contact and collision athletes, the Latarjet procedure is often recommended, transferring a piece of bone with its attached tendon to reconstruct the glenoid and provide a dynamic sling effect for added stability.
Dr Guo gained specialist expertise in the Latarjet procedure and complex shoulder instability surgery during his fellowship at the Centre Orthopedique Santy in Lyon, France, working directly under leading shoulder surgeons Dr Pascal Boileau, Dr Gilles Walch and Dr Arnaud Godeneche.
Recovery
Recovery after Bankart repair or the Latarjet procedure follows a structured rehabilitation programme, with a period of protection in a sling followed by progressive restoration of motion and strength, before a graduated return to sport. Please see our Rehabilitation Protocols section for general post-operative guidelines.
This article is intended for general information only and does not replace a personal consultation. If you have experienced shoulder instability or a dislocation, please arrange an appointment for an individual assessment.