At a glance
Main symptoms
- Severe shoulder pain
- Complete loss of arm use
- Visible shoulder deformity (contour loss)
- Hospital stay
- 1 overnight hospital stay is typical.
- Recovery time
- 3–6 months
- Return to work
- Desk work in 2-3 weeks, standing work in 2-3 months, overhead or heavy work in 4-6 months.
The shoulder joint is the most mobile joint in the body; this high mobility makes it the most commonly dislocated joint. First dislocation is usually caused by trauma (fall, contact sport, accident). If important structural damages (Bankart lesion, Hill-Sachs lesion) are untreated, recurrent dislocations (instability) develop in 70-90% of patients, especially athletes under 20-25.
Symptoms
In initial dislocation:
- Severe shoulder pain
- Complete loss of arm use
- Visible shoulder deformity (contour loss)
- Patient usually holds arm tight to body
- Sometimes numbness in arm or fingers
In recurrent dislocations:
- Feeling shoulder "will dislocate" in certain positions (apprehension)
- Insecurity especially in overhead sports
- Dislocation while sleeping in bad position
- Sometimes spontaneous in-and-out
- Chronic shoulder pain, weakness sensation
Diagnostic Methods
In acute dislocation, clinical findings are diagnostic. X-rays are mandatory; direction (anterior, posterior, inferior) and accompanying bone fractures (Hill-Sachs, bony Bankart) are evaluated. For definitive diagnosis in recurrent dislocations, MR arthrography is the gold standard. In some cases, CT evaluates bone loss.
Treatment Approach
Non-Surgical Treatments
In first dislocation, emergency treatment is closed reduction. Arm is kept in sling for 3-6 weeks, then gradual physical therapy. In athletes under 25, early surgery may be considered even after first dislocation (70-90% recurrence risk). In patients over 40, conservative treatment has high success.
Surgical Treatment
Arthroscopic Bankart repair is today's standard surgery: torn labrum is reattached to bone with special implants called suture anchors. If significant bone loss exists (>20-25%), Latarjet procedure (coracoid bone transfer) or bone block procedures are performed.
Surgical Process
Performed under general anesthesia and interscalene block, patient in lateral or semi-seated position. 3-4 small portals are used. Procedure lasts 1-2 hours.
Hospital Stay
1 overnight hospital stay is typical.
Recovery Process
- Weeks 0-4: Sling, limited passive motion, avoid external rotation
- Weeks 4-8: Active-assisted exercises, sling removed
- Months 2-4: Active exercises, strengthening program
- Months 4-6: Sport-specific exercises
- 6 months: Return to full contact sports
Return to Work
Desk work in 2-3 weeks, standing work in 2-3 months, overhead or heavy work in 4-6 months.
Potential Complications
Complication rate 5-10%. Problems: re-dislocation (5-15%, higher with bone loss), external rotation restriction, frozen shoulder, nerve injury (especially axillary nerve), infection.
Frequently asked questions
Should I have surgery after first dislocation?
Decision based on age, activity level, and imaging findings. In athletes under 25, early surgery significantly reduces re-dislocation risk. In low-activity patients over 40, conservative treatment is tried first.
Will there be re-dislocation after surgery?
Re-dislocation risk after standard Bankart repair is 5-10%. With bone loss cases, procedures like Latarjet reduce this risk further.
Can I continue playing sports?
Yes. After full rehabilitation, return to all sports including contact is possible. Typically competitive sports return in 6-9 months.
This content is for information only and does not replace examination, diagnosis or treatment. The right treatment for you is decided after an examination.