Shoulder instability
Shoulder instability is a common condition, particularly affecting young people and sportspeople. It corresponds to an abnormal loss of contact between the head of the humerus and the glenoid cavity of the scapula, which can lead to complete dislocation.
The shoulder is the most mobile joint in the human body, but also one of the most vulnerable. Its stability depends on a complex balance between bone, ligament, capsular and muscular structures.
When do we talk about shoulder instability?
Instability occurs in the following situations:
- Recurrent shoulder dislocation (several episodes of dislocation),
- Subluxations (sensation of a "loose" shoulder without complete dislocation),
- Painful instability without true dislocation,
- Feeling of joint insecurity during everyday movements or during sport.
Instability may be due to :
- Weakness or damage to the dynamic stabilisers (rotator cuff, joint capsule).
- Initial trauma (traumatic dislocation),
- Constitutional laxity (known as "loose shoulder"),
- Weakness or damage to the dynamic stabilisers (rotator cuff, joint capsule).
Diagnosis of instability
Diagnosis is based on :
- A detailed interrogation to retrace the circumstances of the first episodes,
- A rigorous clinical examination to assess laxity, pain and range of movement,
- Appropriate imaging tests: X-rays, MRI, arthro-scanner to look for associated lesions (Bankart lesion, Hill-Sachs notch).
A full assessment is essential in order to propose the right treatment for each situation.
Treatments for shoulder instability
There are two main treatment options:
- Conservative treatment :
- Functional rehabilitation focusing on muscle strengthening, particularly of the rotator cuff and scapular muscles,
- Advice on modifying sporting activities to avoid risky movements.
This treatment is preferred in the absence of major lesions and in patients who are not very active.
- Surgical treatment :
- Indicated in cases of failure of medical treatment, multiple recurrences or major anatomical lesions,
- Possible techniques: arthroscopic repair of the capsule and labrum (Bankart bone block), Latarjet bone block, depending on the severity of the injury.
The aim of the surgery is to stabilise the shoulder permanently and allow a return to normal activities, including sport.
Course of the operation
Stabilisation surgery is generally performed under arthroscopy (minimally invasive surgery), under general anaesthetic.
The surgical procedure is chosen according to the lesions observed and the patient's history. The operation lasts approximately 1 to 2 hours.
The hospital stay is short, often limited to one night or carried out on an outpatient basis.
Rehabilitation after surgery
Rehabilitation is progressive and supervised:
- Immobilisation of the shoulder in a splint for 3 to 6 weeks,
- Gradual return to passive and then active mobility,
- Specific muscle strengthening and functional re-training.
A return to sport is possible between 4 and 6 months after the operation, depending on the discipline practised.
Expected results
Shoulder stabilisation surgery offers :
- An excellent success rate in preventing repeat offences,
- Recovery of joint function,
- A significant improvement in quality of life and activity levels.
Results are optimised by personalised care and rigorous re-education.
Possible complications
Complications are rare but should be taken into account:
- Joint stiffness,
- Recurrence of instability,
- Nerve damage (exceptional),
- Long-term secondary osteoarthritis.
Careful post-operative monitoring enables any complications to be prevented and treated at an early stage.
Where to have an operation in Paris?
Our teams work in a number of leading establishments in Paris:
For consultations:
- Espace Médical Vauban
- IMSS - Institut Médical Sport Santé
- ARAGO Clinic
For interventions:
- ARAGO Clinic
You will be cared for by recognised specialists: Dr Kerboull, Dr Sailhan and Dr Zilber, experts in hip surgery.
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