If the soft tissues that stabilize the shoulder are torn or strained as a result of a shoulder dislocation, or if you experience frequent dislocations, doctors at NYU Langone recommend surgery to repair or tighten the damaged structures. Surgery may also be needed if a dislocation causes damage to the bones in the joint.
An orthopedic surgeon may recommend surgery for young athletes involved in sports requiring frequent throwing motions or collisions, which increase the risk of recurring dislocations. Surgery may improve joint stability and prevent a future dislocation.
Most of the time, our orthopedic surgeons perform minimally invasive surgery that does not require an overnight hospital stay and speeds recovery time.
Surgery for a dislocated shoulder is often required to tighten torn or stretched tendons or ligaments. A surgeon may also repair a torn labrum, the ring of cartilage that surrounds the shoulder socket and stabilizes the humerus. Together, these soft tissues hold the joint in place. The goal of surgery is to repair or tighten these tissues.
An arthroscopic technique allows NYU Langone surgeons to access the shoulder using very small incisions, minimizing damage to surrounding tissues.
A surgeon performs arthroscopic surgery using a slim, pencil-sized instrument called an arthroscope that is inserted into the joint through a small incision. The arthroscope has a video camera and a light at one end and sends a live video of the inside of the shoulder to a nearby monitor. This clear view of the interior of the joint can be magnified many times to show tiny details in the bones, tendons, ligaments, and labrum.
After positioning the arthroscope, the surgeon inserts small surgical tools through a separate small incision. Using the video as a guide, the surgeon repositions a torn ligament or labrum to the bone.
Arthroscopic surgery is usually performed using general anesthesia. Surgeons often also administer an injection called a nerve block, which temporarily prevents nerve signals from causing pain in the shoulder. A nerve block provides 10 to 12 hours of pain relief after surgery.
At NYU Langone, arthroscopy is an outpatient procedure, which means you can expect to return home within hours of surgery. Doctors may prescribe pain medication for the first week or two. As your shoulder heals and pain lessens, doctors recommend transitioning to an over-the-counter pain reliever.
Doctors recommend immobilizing the arm and shoulder using a sling for four to six weeks while the soft tissues heal. Your doctor monitors healing at a follow-up appointment 10 to 14 days after surgery.
After six weeks, doctors encourage three to six months of physical therapy to rebuild muscle strength and restore range of motion.
If you’ve had arthroscopic surgery and shoulder weakness or pain persists, or if the results of diagnostic imaging tests show changes to the shape of the bones in the joint, a surgeon may recommend open surgery.
“Open” means that surgeons access the joint through a single incision made above the shoulder joint, instead of several small incisions. A doctor may perform open surgery to repair injured tendons, ligaments, or the labrum, or to address damage to the bones of the joint.
To repair bone loss in the glenoid socket caused by repeated injury, the surgeon takes a piece of living bone, called a bone graft, from another part of your body—usually along the top of your hip bone—and shapes it to fit the rim of the glenoid to create a deeper socket. Over time, the bone graft fuses to the shoulder socket to form solid bone. This provides additional stability for the shoulder and helps keep the arm bone in place.
Recovery from open surgery varies depending on the type of procedure your surgeon performs. Some people return home on the same day, and others need to remain in the hospital overnight. Our nurses and pain management specialists are available around the clock to ensure that you have the pain relief medication you need to recover comfortably.
When you return home, your arm is in a sling for two to six weeks to give your shoulder a chance to heal without bearing weight. The sling can be removed when you eat and sleep. Your surgeon schedules a follow-up visit for 8 to 10 days after surgery to make sure the joint is healing normally and determine when physical therapy should begin.
Doctors may recommend physical therapy for four to eight weeks. During the first four weeks, physical therapists use approaches such as heat and massage therapy to relieve pain and inflammation. As the shoulder heals and pain recedes, your therapist gradually incorporates stretching and strengthening exercises for the muscles of your shoulder, arm, and upper back to help restore range of motion and provide long-term stability.
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