SHOULDER INSTABILITY
Recurrent Shoulder
Instability
For some patients, the first shoulder dislocation is also the last. For others, the shoulder continues to slip out repeatedly with less and less force. Recurrent instability can lead to additional damage to the labrum, cartilage, and bone, making treatment progressively more complex over time.
Repeated Dislocations
Progressive Damage
Depends On Why It Recurs
Permanent Stability
Why Does The Shoulder Keep Dislocating?
The first dislocation frequently tears the labrum and stretches or tears the stabilizing ligaments of the shoulder. If those structures fail to heal adequately—or if significant bone loss develops—the shoulder becomes increasingly susceptible to additional instability episodes.
Each recurrent dislocation can create new damage, making future instability even more likely.
Dr. Streit's Clinical Perspective
One of my biggest goals is to stop the cycle of instability before repeated dislocations permanently change the shoulder. Every instability episode has the potential to increase bone loss, enlarge a Hill-Sachs lesion, damage cartilage, and make future surgery more difficult.
Signs Of Recurrent Instability
Repeated Dislocations
The shoulder comes completely out of socket multiple times.
Subluxations
The shoulder partially slips out before relocating on its own.
Apprehension
You avoid certain positions because the shoulder feels unstable.
Loss Of Confidence
You no longer trust the shoulder during sports or daily activities.
Progressively Easier Dislocations
The amount of force needed to dislocate the shoulder decreases over time.
Persistent Pain
Pain may continue because of associated labral, cartilage, or bone injuries.
What Damage Can Repeated Dislocations Cause?
Labral Injury
The labrum may become increasingly detached or difficult to repair.
Glenoid Bone Loss
Repeated instability may gradually wear away the front of the socket.
Hill-Sachs Lesion
The compression injury to the humeral head may enlarge with each event.
Cartilage Damage
Additional instability episodes may increase the risk of arthritis later in life.
Ligament Stretching
Soft tissues become progressively less effective stabilizers.
More Complex Surgery
Progressive bone loss may require a Latarjet procedure instead of an arthroscopic repair.
How Is Recurrent Instability Evaluated?
A complete evaluation includes understanding every instability episode, your activity level, your goals, and careful imaging to identify bone loss and soft tissue injury.
History
Physical Examination
MRI
CT Scan
When Is Surgery Recommended?
Many patients with recurrent instability benefit from surgical stabilization because the shoulder has demonstrated that it cannot reliably remain stable during everyday activities or sports.
The specific operation depends on the amount of bone loss, the condition of the labrum and ligaments, the size of any Hill-Sachs lesion, your sport, and your long-term goals.
What I Tell My Patients
"My goal isn't simply to repair today's injury. My goal is to restore a shoulder that remains stable for decades while preserving as much normal anatomy and function as possible."
Possible Surgical Procedures
Arthroscopic Bankart Repair
Latarjet Procedure
Revision Stabilization Surgery
Related Resources
Is Your Shoulder Continuing To Dislocate?
A detailed evaluation can identify why your shoulder remains unstable and determine whether arthroscopic stabilization or a bone augmentation procedure offers the best chance of preventing future dislocations.
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