What is shoulder instability?

The shoulder joint is made up of a ball (the head of the humerus) and a socket (the glenoid). The socket is shallow, with an inner lining of cartilage (the labrum). The ball is kept in place by soft tissues such as muscles and ligaments.

Shoulder instability happens when there is a problem with the labrum or the soft tissues, causing symptoms such as pain, dislocation and a feeling of looseness.

What are the benefits of surgery?

You should get less pain and fewer dislocations and your shoulder should not feel as loose. You may not get back the same strength and range of movement that you had before you damaged your shoulder.

Are there any alternatives to surgery?

Most people can get back good function in their shoulder by changing their activities, and with the help of exercises and physiotherapy.

Simple painkillers such as paracetamol and anti-inflammatory painkillers such as ibuprofen can also help.

A steroid and local-anaesthetic injection into your shoulder can sometimes reduce pain for several months but may cause side effects if repeated too often.

What will happen if I decide not to have the operation?

Your surgeon may recommend physiotherapy to help strengthen the muscles in your shoulder.

If your shoulder continues to be unstable, you may get further damage to your shoulder joint.

What does the operation involve?

The operation is usually performed under a general anaesthetic but various anaesthetic techniques are possible.

The operation usually takes 45 minutes to two hours.

Your surgeon will make three or four small cuts at the front and back of your shoulder and on the side of your upper arm.

They will insert surgical instruments through the cuts along with a telescope so they can see inside your shoulder and perform the operation.

Your surgeon will use the instruments to remove any scar tissue, release the damaged tissue and repair the torn labrum and ligaments back into the right position.

How can I prepare myself for the operation?

If you smoke, stopping smoking several weeks or more before the operation may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious and may even cause death.

General complications of any operation

• Bleeding during or after the operation.
• Infection of the surgical site (wound).
• Allergic reaction to the equipment, materials or medication.
• Chest infection — your risk will be lower if you have stopped smoking and you are free of Covid-19 (coronavirus) symptoms for at least 7 weeks before the operation.

Specific complications of this operation

• Bleeding into your shoulder. You may need a further arthroscopy to wash out your shoulder.
• Restricted shoulder movement (frozen shoulder).
• Infection in your shoulder.
• Blood clot (thrombosis) in the axillary vein, which is just under your shoulder joint. You will get a swollen arm and will need further treatment.
• Severe pain, stiffness and loss of use of your arm and hand (complex regional pain syndrome - CRPS). Your arm and hand can take months or years to improve.
• Damage to nerves around your shoulder, leading to weakness, numbness or pain in your shoulder or arm. This usually gets better but may be permanent.
• The shoulder continuing to be unstable or to dislocate.
• Difficulty passing urine. If it gets worse (bladder retention) you may need to go home with a urinary catheter and come back to hospital to have it removed around 2 weeks later.

Consequences of this procedure

• Pain.
• Unsightly scarring of your skin. The risk is higher if you have open surgery.

How soon will I recover?

You should be able to go home the same day. However, your doctor may recommend that you stay a little longer.

The physiotherapist may give you exercises and advice to help you to recover from the operation. Follow any instructions carefully to improve the chance of getting strength and movement back in your shoulder.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

8 in 10 people have a major improvement but it takes time for pain to lessen and movement to increase.

Summary

An unstable shoulder can cause pain, a feeling of looseness in your shoulder joint and dislocation. An operation can help to reduce any pain and allow you to use your shoulder.

IMPORTANT INFORMATION

The operation and treatment information on this page is published under license by Healthdirect Australia from EIDO Healthcare Australia and is protected by copyright laws. Other than for your personal, non-commercial use, you may not copy, print out, download or otherwise reproduce any of the information. The information should not replace advice that your relevant health professional would give you.

For more on how this information was prepared, click here.