Treatment of shoulder dislocation

Treatment of shoulder dislocation aims both to provide immediate relief and to prevent recurrent instability and long-term complications. At Mashtaler Ortho&Trauma Clinic, an integrated approach is used, combining surgical techniques and rehabilitation. This helps reduce the risk of recurrence and preserve joint mobility.

Recurrent shoulder dislocation — what is the underlying problem?

 Recurrent shoulder dislocation is a manifestation of shoulder joint instability. It typically develops after injury to the glenoid labrum and damage to the capsuloligamentous structures of the joint. When these structures heal improperly, they are no longer able to stabilize the humeral head.

As a result, repeated dislocations may occur even with minimal load. This condition is associated with pain, discomfort, and limited mobility. Patients often begin to avoid using the affected arm, which can lead to compensatory overload and secondary musculoskeletal problems.

Symptoms of shoulder dislocation

 Acute shoulder dislocation is characterized by:

• severe pain, which increases with movement;
• marked limitation of motion;
• visible deformity of the shoulder contour;
• inability to use the arm normally.

The habitual dislocation of the shoulder is a chronic problem that usually develops as a result of rupture and incapacity of the structures that stabilize the shoulder.

Symptoms of recurrent instability

Acute shoulder dislocation is characterized by:

• severe pain, which increases with movement;
• marked limitation of motion;
• visible deformity of the shoulder contour;
• inability to use the arm normally.

Symptoms of recurrent instability

Recurrent dislocation presents as a chronic condition with the following features:

• repeated dislocations, sometimes even during minor movements;
• subluxations (partial dislocations) that spontaneously reduce;
• a persistent feeling of instability, especially when the arm is abducted or externally rotated;
• chronic pain and weakness due to soft tissue damage.

Diagnosis of shoulder instability

At Mashtaler Ortho&Trauma Clinic, diagnosis is based on a comprehensive clinical and imaging evaluation:

• Medical history. Frequency of dislocations, mechanism of injury, and provoking movements are assessed.
• Apprehension test. A clinical test used to detect instability when the arm is positioned in abduction and external rotation.
• X-ray imaging. May reveal bone defects such as a bony Bankart lesion or Hill-Sachs lesion.
• MRI. The most informative method for assessing soft tissue injuries, including labral tears and capsular damage.
• CT scan. Used to evaluate bone loss of the glenoid, which is critical for surgical planning.

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Treatment methods for shoulder dislocation

Treatment depends on the severity and type of instability and may be conservative or surgical.

Immobilization

 In cases of first-time dislocation, conservative treatment is usually recommended. After reduction of the joint, the arm is immobilized in a sling for approximately 2–3 weeks to allow healing of the capsule and ligaments.

Physiotherapy and rehabilitation

  A structured rehabilitation program focuses on strengthening the rotator cuff and scapular stabilizers. Exercises include resistance training, isometric strengthening, and controlled stretching. Load progression is gradual to prevent recurrence.

Bankart repair

 Bankart repair is a minimally invasive arthroscopic procedure. The surgeon reattaches the torn labrum to the glenoid and restores capsular tension. This stabilizes the joint and prevents recurrent dislocation.

The arm is typically immobilized for 3–4 weeks, followed by rehabilitation. Full recovery may take up to 4–6 months.

Latarjet procedure

The Latarjet procedure is indicated in cases of significant bone loss or failed previous stabilization. A bone graft (coracoid process) is transferred to the anterior glenoid to increase stability and prevent anterior displacement of the humeral head.

This procedure has a high success rate (up to 90–95%). Immobilization lasts 4–6 weeks, and full recovery may take up to 6 months.

Why shoulder instability should not be ignored

Without treatment, dislocations may become recurrent. Each episode further damages cartilage and bone, increasing the risk of osteoarthritis and progressive bone loss.

In addition, patients often develop fear of movement, which leads to reduced activity, muscle weakness, and chronic discomfort.

If you suspect a shoulder dislocation or instability, early evaluation is essential to exclude other conditions such as impingement syndrome, adhesive capsulitis, or osteoarthritis and to choose the most appropriate treatment.

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Cost of treatment for shoulder instability

 The cost depends on the severity of the condition, chosen treatment method, and individual patient factors. A detailed treatment plan and cost estimate are provided during consultation.