The introduction of movement should be as early as possible, but at the same time the movement should be safe for the healing tissues. The aim of the procedure will be to improve the stability of the shoulder joint thanks to the activity of the appropriate muscles, gradually restore the range of motion and increase the strength and endurance of the muscles of the upper limb.
The physiotherapist will advise the patient to exercise the muscles stabilizing the head of the humerus in the joint socket and exercises to improve the range of motion. Remember that the exercises should be introduced gradually. The patient should be under the constant care of the attending physician and physiotherapist.
During dislocation, the labrum of the acetabulum is often severed in the antero-inferior region – the so-called Bankart injury. If the injury is severe, the acetabular bone and the head of the humerus may be damaged, and the cartilage may be damaged. In older patients, the rotator cuff is often damaged or the greater tubercle of the humerus is fractured. In the vast majority of cases, damage to the acetabular labrum leads to repeated dislocations, which in turn cause further detachment of the acetabulum.
We are talking then about instability of the shoulder joint. A consequence of the instability is habitual dislocation of the joint, which occurs during normal abduction and rotation movements. Often, during such dislocations, the head of the humerus spontaneously returns to its place or the patient is able to adjust the joint by himself. However, recurring dislocations are dangerous – in extreme cases they can completely destabilize the joint.
Patients suffering from habitual dislocations of the barium joint develop pain when performing certain movements. Sometimes jumping the joint is accompanied by a characteristic “click”. Patients are afraid of performing certain movements and the instability of the joint sometimes prevents them from performing certain activities or playing sports. Untreated habitual dislocations lead to limb weakness and significant discomfort. In the case of damage to the labrum of the acetabulum, it is necessary to undergo surgical treatment.
Surgical treatment of shoulder instability
The aim of the operation is to reattach the acetabular labrum in its anatomical place. Depending on the type of injury, anatomical conditions and the degree of damage to the labrum, the operation can be performed arthroscopically or with the classic opening of the joint. When the injury is extensive, the labrum has been irreversibly damaged, or the patient has also had bone damage to the joint, the classic open procedure is performed. The most popular, most often performed and giving the best results is the so-called Operation Bristow-Latarjet.