Shoulder instability can occur for a few different reasons. One cause of shoulder instability is a traumatic event causing the shoulder to dislocate, which may occur while playing high intensity contact sports or even with a fall. If the shoulder doesn’t heal properly, this can cause repeated instability events to occur. Another reason recurrent instability may happen is due to a naturally loose shoulder. In this case, the soft tissues (labrum and capsule) are repeatedly stretched and no longer provide support or stabilization to the shoulder. Patients often complain about the shoulder slipping out of socket, feeling weak, and occasionally painful when these instability events occur.
An initial form of treatment is conservative in nature. These include resting the shoulder, participating in physical therapy to help strengthen the shoulder, and possibly using anti inflammatory medication to help with soreness or pain. If these treatments don’t seem to be improving the stability of your shoulder, the next step is evaluation by a physician to determine the best treatment plan. For chronic instability, meaning repeated subluxations or dislocations of the shoulder, a capsulorrhaphy may be the best option. A capsulorrhaphy is a surgical procedure that repairs and tightens the shoulder capsule, the connective tissue around the shoulder, to help stabilize the ball and socket.
A capsulorrhaphy is a surgical procedure that repairs and tightens the shoulder capsule, the connective tissue around the shoulder, to help stabilize the ball and socket. It is an arthroscopic procedure that is performed through three to four small (arthroscopic) incisions. One incision is used for visualizing with the camera (arthroscope), while the others are used to insert surgical tools and instruments that are used for the repair. The capsule surrounding the entire shoulder is repaired using a construct of small sutures, which then tighten the capsule by being anchored down to the glenoid bone.
This is an outpatient procedure that typically takes about one and a half to two hours. You are placed in a special brace called a Gunslinger that completely immobilizes your shoulder for the first six weeks after surgery. After six weeks, you may remove the Gunslinger and begin gentle therapy under the guidance of a physical therapist. Approximate recovery time is six months.