Treatment of repeated dislocation
Shoulder dislocation treatment depends on age of patient, current activity level, number of episodes of dislocation, type of sports participation and severity of injury to soft tissue and bone.
Goal of treatment is to prevent further episodes of dislocation by nonsurgical (functional rehab) or surgical (arthroscopic, a key-hole procedure) and to restore shoulder function.
Treatment of Shoulder Dislocation
Shoulder being most mobile joint in the body, so is also more unstable joint.
In shoulder dislocation, the ball (proximal humerus) is separated from socket (glenoid) either completely or partially (subluxation).
Shoulder joint dislocates following a severe trauma, fall or becomes partially unstable following repetitive activity in throwing athletes.
 Usually with every episode of dislocation there is associated injury to supporting structures like ligaments, cartilage tissue (labrum) or glenoid bony edge.
The torn labrum never heals on its own and there is further damage to bone with every further episode of dislocations and then making the treatment more complex -to repair soft tissue and to reconstruct bone loss (bone grafting or Laterjet).
Emergency Treatment
First time dislocation is very painful and needs emergency treatment in which attending Orthopedic Surgeon reduce the shoulder joint in place underanaesthesia. Check x-rays are taken to confirm proper repositioning of shoulder joint and to rule out fracture of proximal humerus associated with dislocation. After reduction the shoulder patient is advised to apply ice and shoulder is immobilized in a sling for two weeks.
In follow up visit patient is examined by Dr. Abhijit Ranaware where he may advise MRI to check for associated injury to ligaments and labrum. CT scan will show amount of bone damage and helps in further planning of the treatment.
The non-surgical treatment is indicated in patients with subluxation as in overhead athletes or in those who have inherent joint laxity. Physiotherapy in the form of functional rehabilitation is the first line treatment for patient with repeated subluxation and joint laxity. Exercises to strengthen the muscles surrounding the shoulder joint, to improve shoulder joint sense (proprioceptive exercises) and to restore stability for sports activity.
A surgical treatment is advised in cases of persistent shoulder instability and repeated shoulder dislocations. Arthroscopic surgery is done to repair the torn labrum (specialized form of cartilage at edge of socket) and tighten the injured ligaments. These soft tissues are repaired with special type of implant like suture anchors.
Torn labrum repaired using suture anchors, done by open or arthroscopic surgery
This minimally invasive arthroscopic technique helps faster recovery and early return to sports in athletes. Sometimes patients involved in contact sports and with history of repeated dislocations are treated by Dr. Abhijit Ranaware with complex bony reconstructive procedure like Laterjet or bone grafting procedure to compensate associated bone loss.
Dr. Abhijit Ranaware, Shoulder and Arthroscopy Surgeon in Pune is highly skilled to treat repeated shoulder dislocation and instability with minimally invasive surgery techniqueand helps athletes in returning to sports to pre-injury level.
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Post surgery rehab
Rest for 3 weeks with sling. Supervised physiotherapy in the form of muscle strengthening exercises and neuromuscular training exercise are advised under guidance of Sports. Physiotherapist.
Post-operative physiotherapy plays important role for a sports person to return to play.