Shoulder Stabilisation Surgery
Shoulder stabilisation surgery is a type of surgery aimed at repairing damaged tissue in the shoulder joint to restore stability and reduce pain. It is commonly performed to address recurrent dislocations or instability caused by injuries such as a torn labrum, damaged ligaments, or bone defects in the shoulder socket.
What is shoulder instability?
Shoulder instability occurs when the shoulder joint becomes loose or repeatedly slips out of place, often due to dislocations or damage to the surrounding soft tissues.
While it can affect people of all ages, younger individuals, particularly those between the ages of 17 and 23, are more prone to shoulder instability due to higher levels of physical activity. In this age group, a first-time dislocation carries a greater risk of recurrence. In some cases, orthopaedic surgeons may recommend surgery after the initial dislocation to help prevent future episodes and restore joint stability.
Common causes of shoulder instability include:
- Torn labrum – the cartilage that stabilises the joint
- Capsular tear or laxity – damage or looseness in the joint capsule, which supports the joint
- Damage to the glenoid rim – the edge of the socket that helps keep the joint in place
- Damage to the humeral head- the top of the arm bone that makes up the shoulder joint
These injuries can weaken the joint and make further dislocations more likely. Symptoms that may signal shoulder instability include:
- Ongoing pain
- Limited range of motion
- Repeated dislocations
The shoulder joint and its components
The shoulder joint, known as the glenohumeral joint, is the most flexible joint in the human body. It is made up of several important structures that work together to provide both stability and a wide range of motion. The humeral head is the ball-shaped top of the upper arm bone, which fits into the glenoid socket, a shallow cup in the shoulder blade. Surrounding the socket is the labrum, a ring of cartilage that helps deepen the socket and stabilise the joint. The rotator cuff, made up of muscles and tendons, supports the shoulder’s movement and keeps the joint in place. Encasing the entire joint is the joint capsule, a strong, fibrous tissue that protects and maintains the structure of the shoulder. These components work in harmony to allow you to lift, rotate, throw, and reach with ease.
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Ways to payBefore surgery
Initial consultation
Before undergoing shoulder stabilisation surgery, you’ll begin with a consultation where your orthopaedic surgeon will assess your symptoms and conduct a detailed examination. Diagnostic tests such as X-rays, MRI scans, or blood tests may be performed to evaluate the extent of damage and confirm the cause of your shoulder instability. These tests help identify issues like joint dislocation, ligament or labral tears, capsular damage, or, less commonly, potential blood clots. Once your consultant clearly understands which part of the shoulder is affected, they’ll talk you through your treatment options and decide whether surgery is the right path for you. If surgery is recommended, you’ll be guided through the preparation process to ensure everything is in place for a smooth experience.
Preparing for surgery
In the days leading up to your shoulder stabilisation surgery, your medical team will provide you with specific instructions to help reduce risks and promote a successful outcome. You may be advised to stop taking certain medications, especially those that increase bleeding risk. Avoiding heavy lifting or strenuous activity is also important to prevent further injury before the procedure. You should follow any fasting guidelines about when to stop eating or drinking. It’s also essential to let your anaesthetist know about any allergies or underlying health conditions, so that they can tailor your care safely. Lastly, make sure you’ve arranged a ride home, as you won’t be able to drive yourself afterwards.
During surgery
Shoulder stabilisation surgery is designed to restore stability to the joint and prevent future dislocations. Depending on the type and severity of your shoulder damage, your surgeon will choose between two main surgical techniques: the Latarjet procedure or Bankart repair.
The Latarjet procedure is usually done as an open surgery (through a larger incision) when there is bone loss at the front of the shoulder socket. In this procedure, a small piece of bone from the shoulder blade (called the coracoid process) is moved and attached to the front of the socket to help reinforce it. This makes the joint more stable and helps prevent future dislocations, especially in people who have had repeated shoulder problems due to bone damage.
The Bankart repair is often done using arthroscopic (keyhole) surgery, which means the surgeon uses small incisions and a camera to guide tiny instruments inside the shoulder. In this procedure, torn soft tissues, like the labrum or ligaments, are reattached to the socket using special sutures or anchors. Because it’s minimally invasive, this technique usually leads to less pain after surgery, a quicker recovery, and smaller scars.
After surgery
Recovery from shoulder stabilisation surgery varies depending on the procedure and individual factors, but there are general stages you can expect. Once home, it’s important to follow all post-operative instructions from your surgeon. You’ll likely wear a sling for several weeks to immobilise your shoulder and protect the repair. Over the first 2-4 weeks, swelling should subside, and you may begin to regain gentle mobility. A follow-up appointment will be scheduled to assess your recovery, including checking the surgical site, pain levels, muscle strength, and shoulder stability. Physical therapy often starts around this time to help restore range of motion and gradually build strength. While many people can resume light daily activities within 6-8 weeks, a full return to sports or physically demanding work may take 4-6 months. If you continue to experience pain, weakness, or a sense of instability, your doctor may recommend additional physiotherapy to support recovery and prevent future dislocations.
Risks and complications
As with any surgical procedure, shoulder stabilisation comes with certain risks and potential complications. These may include infection, nerve injury, shoulder stiffness (sometimes referred to as frozen shoulder), and the possibility of the joint becoming unstable again. In some cases, the hardware used during the surgery, such as suture anchors, may cause irritation or require removal in a second procedure.
Appointment and Treatment Plan
Initial Consultation
Your journey begins with a consultation with an orthopaedic specialist. If you’re experiencing shoulder dislocations, pain, or weakness, especially during activity, your doctor will conduct a physical examination and order imaging tests such as an MRI or X-ray. These help confirm whether there’s a tear in the labrum, joint capsule, or bone loss around the glenoid. If conservative treatments like physiotherapy, rest, or medications haven’t worked, surgery may be recommended to restore stability to the shoulder joint.
Pre-Surgery Preparations
Once surgery is planned, you’ll receive specific instructions to follow in the days beforehand. This might include stopping blood-thinning medications, fasting for several hours before surgery, and avoiding smoking to help promote healing. You’ll also need to arrange for someone to take you home, as you won’t be able to drive after the procedure. Your healthcare team may also suggest preparing your home to make your recovery period easier and safer.
Day of Surgery
Shoulder stabilisation surgery is typically done as a day procedure and lasts between 1-2 hours. Depending on the type of instability and the extent of damage, your surgeon may perform either a Bankart repair using minimally invasive arthroscopy or a Latarjet procedure if there’s significant bone loss. You’ll be given either general or regional anaesthesia, and in many cases, a nerve block will also be used to reduce pain during and after surgery.
Immediately After Surgery
After the operation, your shoulder will be bandaged and placed in a sling to immobilise the joint. If a nerve block was used, your arm may feel numb or heavy for several hours. Some pain and swelling are normal, and your care team will provide medication and guidance to help manage these symptoms at home. Resting, icing, and keeping your arm elevated as recommended will support the healing process in the first few days.
Early Recovery at Home
During the initial recovery period, typically the first two to four weeks, you’ll continue wearing a sling to protect the surgical repair and prevent movement. You may be advised to begin gentle passive physiotherapy, where a therapist moves your arm for you, without active effort on your part. It’s important to avoid lifting, reaching, or bearing weight on your arm during this stage to prevent re-injury.
Physiotherapy and Rehabilitation
Your physiotherapist will guide you through a personalised rehab plan as healing progresses. Around 4-6 weeks after surgery, you’ll be able to start active range-of-motion exercises to improve flexibility and movement. As your shoulder becomes more stable, strengthening exercises will be introduced to rebuild the rotator cuff and supporting muscles. Rehabilitation is key to restoring full function and avoiding future dislocations.
Full Recovery
Recovery timelines vary depending on the type of procedure and the individual. Most people return to light daily activities in about 6- 8 weeks. However, full recovery, especially for athletes or people in physically demanding jobs, can take between 4 and 6 months, or longer in some cases. With consistent physiotherapy and care, most patients regain strong shoulder stability and a good range of motion, allowing a safe return to sports or active work.
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FAQs
The recovery time for shoulder stabilisation surgery typically ranges from 6-8 weeks for most patients to return to normal daily activities. However, full recovery, including regaining complete strength and range of motion, may take several months, depending on the extent of the injury and the type of surgery performed. During the initial weeks after surgery, patients usually wear a sling to immobilise the shoulder and promote healing. Physical therapy plays a vital role in recovery, with gradual introduction of motion exercises followed by strengthening programs to restore shoulder stability and function.
Pain levels after shoulder stabilisation surgery can vary based on the individual and the specific procedure performed. Generally, arthroscopic shoulder stabilisation tends to result in less post-operative pain compared to open surgery due to smaller incisions and less tissue disruption. Pain control methods such as nerve blocks, medications, and ice therapy are commonly used to manage discomfort during the recovery period. Most patients experience a gradual reduction in pain over several weeks as the shoulder heals and mobility improves.
Shoulder stabilisation surgery is a type of surgery aimed at repairing damaged tissue in the shoulder joint to restore stability and reduce pain. It is commonly performed to address recurrent dislocations or instability caused by injuries such as a torn labrum, damaged ligaments, or bone defects in the shoulder socket. The surgery may involve arthroscopic techniques using small incisions or open procedures like the Latarjet procedure, depending on the severity and nature of the injury. The goal of the surgery is to restore the normal structure and function of the shoulder joint, allowing patients to regain control and return to their regular activities, including contact sports.
Surgery for shoulder instability is usually considered when conservative treatments like physical therapy and strengthening exercises fail to provide adequate stability or when recurrent dislocations continue to occur. Patients who participate in contact sports or activities involving heavy objects and repetitive shoulder use may require surgical intervention sooner to prevent further damage. Additionally, young patients experiencing their first dislocation between the ages of 17 and 23 often face a higher risk of recurrent instability, making early surgical stabilisation a recommended option. The decision for surgery is made after careful evaluation by an orthopaedic surgeon, considering factors such as the extent of damaged tissue, patient activity level, and overall shoulder function.
Medically reviewed by Mr Nawfal Al-Hadithy - Consultant Trauma & Orthopaedic Shoulder, Elbow & Hand Surgeon on 28/05/2025