Shoulder Dislocation, THINGS TO KNOW!

Shoulder dislocation is the price we pay for the extensive shoulder mobility we enjoy.

What are the chances that my shoulder can dislocate again?
The chances of recurrence decreases with the increasing age of the patient. So dislocations in young individuals is always a matter of concern. It has to be taken seriously and proper treatment taken. The recurrence rate can reach upto 95% in young individuals.  The cause of recurrence in younger individuals is disruption of the capsulo labral complex. The causes in middle age to elderly varies. We need to rule out rotator cuff tear and bony defect alongwith labral tear in elderly.

Why do you think my second dislocation will possibly happen?
Second dislocation happens as there is non functional, dislocation preventive mechanism. The capsule labral complex is normally attached to the glenoid and prevent any kind of dislocations in spite of great range of movement. This is torn during first dislocation. The nature is not capable in healing the capsule labral complex back to the original position in spite of long conservative treatment. The shoulder will keep on dislocating every now and then till it is sutured back.

How can my second dislocation happen?
Second dislocation can happen in a variety of fashion. You must be very careful once you have had one dislocation. Any trivial trauma can now lead to dislocation as the protective mechanism has been disrupted. Arm in cricket ball throwing position has to be avoided as this can easily dislocate the shoulder. Some people dislocate the shoulder while asleep. Epilepsy , if present, has to be well controlled.

What are the ways I can prevent the subsequent dislocations?
There are multiple number of ways in which you can prevent the recurrence of shoulder dislocation. The first and the foremost is the proper treatment taken during the first dislocation episode. You need to immobilize the affected shoulder as per doctors advice. Lifestyle modification is very crucial. Any kind of high impact sports should be avoided. Arm in the throwing position is at the greatest risk of dislocation and hence avoid this to prevent the second dislocation.

Does recurrence of dislocation harm me?
This is a very interesting concept. With every increase in number of dislocations you are increasingly damaging the bones. The two bones of the shoulder joint, namely glenoid of scapula and head of humerus hit each others during a dislocation. As the dislocation is a high impact process, a lot of bone is damaged permanently with each disloaction. Therefore, more the number of dislocations allowed, more will be the bone damage. Hence, you should never allow multiple number of dislocations . Seek medical help as soon as possible.

What is the permanent solution?
The permanent solution to the recurrence of shoulder dislocation is surgery. The surgery done in the modern times is minimally invasive and patient gets discharged same day or next day after surgery. Name of the surgery is Arthroscopic Bankart Repair. The labrum tissue that is torn during the wild trauma which dislocated the shoulder is sieved back to its original position. This is a complex procedure and hence visiting a shoulder specialist doctor is best for superior results. If more number of dislocations are allowed, the effectiveness of the arthroscopic surgery decreases and more aggressive open surgery is required to get desired results.  Hence best is to get treated on proper time.

Can my shoulder dislocate again after surgery?
The shoulder post surgery normally does not dislocate again. However repeated trauma to the same shoulder will not guarantee a stable shoulder. This, in fact, holds true for any virgin shoulder.