SHOULDER INSTABILITY

Recurrent Shoulder
Dislocations

Once a shoulder has dislocated, the risk of another dislocation often increases—especially in young, active patients. Recurrent instability can lead to progressive damage to the labrum, bone, cartilage, and rotator cuff, making treatment more complex over time.

Dislocation

Shoulder Comes Out Of Socket

Damage

Labrum & Bone Can Worsen

Recurrence

Risk Increases After First Event

Goal

Prevent Future Injury

Why Does The Shoulder Keep Dislocating?

The first dislocation often tears the stabilizing structures of the shoulder, including the labrum and ligaments. In some patients, these tissues do not heal well enough to restore normal stability, allowing the shoulder to slip out again with sports, falls, or even routine activities.

Risk Factors For Recurrence

  • Young age
  • Contact or collision sports
  • Overhead athletics
  • Generalized ligamentous laxity
  • Large labral tears
  • Bone loss

Common Symptoms

  • Repeated dislocations
  • Shoulder "slipping out"
  • Apprehension with overhead motion
  • Pain after instability events
  • Loss of confidence in the shoulder
  • Difficulty returning to sports

Why Repeated Dislocations Matter

Each instability event has the potential to cause additional damage. As bone loss increases and the labrum becomes more damaged, surgical reconstruction often becomes more complex.

Labrum

Progressive tearing of the stabilizing cartilage.

Bone Loss

Loss of bone from the front of the glenoid can reduce stability.

Hill-Sachs Lesion

Compression fracture of the humeral head may enlarge with repeated dislocations.

Cartilage

Repeated instability may contribute to premature arthritis.

Dr. Streit's Clinical Perspective

One of my primary goals is to prevent the second, third, and fourth dislocation—not simply treat the shoulder after repeated instability has caused additional damage. In young active patients, early stabilization is often the best way to preserve bone, cartilage, and the long-term health of the shoulder.

Every patient is different, but recurrent instability is rarely a problem that improves simply by waiting.

Choosing The Right Operation

The best procedure depends on your age, activity level, bone loss, soft tissue injury, and previous surgeries.

Bankart Repair

Often recommended when bone loss is minimal and the labrum can be repaired arthroscopically.

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Bankart + Remplissage

Used when a significant Hill-Sachs lesion is present without substantial glenoid bone loss.

Latarjet Procedure

Preferred for significant glenoid bone loss, certain collision athletes, or failed prior Bankart repair.

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When Is Surgery Recommended?

  • Recurrent shoulder dislocations
  • Persistent instability despite rehabilitation
  • Young athletes after a first traumatic dislocation with high risk of recurrence
  • Bone loss or significant structural injury
  • Inability to safely return to sports or work

Related Resources

Ready To Discuss Your Shoulder?

Whether you've experienced your first dislocation or have recurrent instability, a careful evaluation can help determine the most appropriate treatment and reduce the risk of future shoulder damage.

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