Overview – Recurrent Shoulder Dislocation
“Kandhe kaa baar baar utar jaana”, this is what masses refer to as recurrent shoulder dislocation in India. This entity is as old as humankind. The extraordinary mobility we enjoy at the shoulder joint comes at the cost of instability.
The shoulder joint is a shallow ball and socket joint. The shallowness of the bony socket is the cause of its mobility as well as instability. The nature tries to stabilize the shallow joint by providing extra protective layers in the joint. Protective layer mainly includes labrum which technically deepens the joint and capsule with its supporting structures.
Any kind of injury, be direct or indirect may tear the supporting structures leading to shoulder dislocation. The fact that these supporting structures rarely heals by themselves, lays the foundation stone for the recurrence of shoulder dislocation.
How common is shoulder dislocation?
Around 20 people every lakh of population has this problem. It is commonly found in young males who are active in sports. Anyone of any age with injury may present with the same. Most common type is anterior dislocation compared to posterior and inferior variety. What makes shoulder dislocations unique is its rate of recurrence. You would be amazed to know shoulder dislocation recurrence in an individual aged less than 20 years approaches near 100 percent.
The rate of recurrence decreases with age, but no age category is immune to it. The lax people are more prone to recurrent dislocations.
Non treatment increases the chances of shoulder glenohumeral osteoarthritis. The more the number of dislocations allowed, higher will be the bone damage and less favourable is the outcome.
Treatment options
The treatment of this condition includes variety of options. This ranges from no treatment available in the older days to treatment by untrained personnel commonly called “pehelvan” in India to the modern day scientific approach. The problem is tackled in a very systematic way presently.
MRI is done to confirm the tear of labrum, to know the exact location of tear as well as the severity of the tear. Other causes of dislocation are also ruled out with the MRI. Treatment protocol is designed accordingly. Acute dislocations are an emergency and are dislocated on immediate basis.
The treatment of recurrence ranges from proper immobilization after the first dislocation to arthroscopic tissue repair to Latarjet surgery. This is a decision taken by shoulder surgeon taking into consideration the age, method of dislocation, number of dislocations, tissue quality and patient’s lifestyle clubbed with his expectations. The results are excellent with modern treatment options and sportsmen are able to rejoin their sports post treatment. It is worth visiting your shoulder surgeon before taking any decision.