Shoulder Instability &
Dislocation
Recurrent shoulder dislocations and chronic instability — understanding your condition and when surgery provides lasting relief.
What is Shoulder Instability?
Shoulder instability occurs when the structures that hold the shoulder joint in place — the labrum, capsule, and ligaments — are stretched or torn, allowing the humeral head to move excessively within the socket. This can range from a vague sense of looseness to complete dislocation, where the ball comes fully out of the socket.
A first dislocation almost always involves a labral tear (Bankart lesion). In younger, active patients, the risk of recurrent dislocation after a first event is very high — up to 90% in athletes under 20. Without surgical stabilization, repeated dislocations cause progressive damage to the joint.
Surgical Treatment
Arthroscopic Bankart repair is the gold standard for young, active patients with anterior shoulder instability. The torn labrum is reattached to the glenoid using suture anchors, restoring the normal restraining mechanism of the shoulder. Performed arthroscopically, it is an outpatient procedure with excellent long-term stability rates of 85–95% in appropriate candidates.
For patients with significant bone loss (engaging Hill-Sachs lesion or bony Bankart), a more involved procedure such as the Latarjet may be required. Dr. Vasileff will evaluate bone loss on MRI and CT scan and discuss the most appropriate approach for your anatomy.
Who Should Have Surgery?
Surgery is strongly recommended for young, active patients — especially athletes — after a first dislocation, given the very high recurrence rate. For older or less active patients, physical therapy focusing on rotator cuff and periscapular strengthening can adequately control instability symptoms in many cases.
Dr. Vasileff will walk you through the risk-benefit analysis specific to your age, activity level, and sport demands before making a recommendation.
Had a shoulder dislocation?
Don't wait for the second one. Early stabilization prevents progressive joint damage.