Habitual dislocation in the shoulder joint

Habitual dislocation in the shoulder joint is a condition in which the humerus is displaced forward or backward from the articular cavity of the scapula without adequate injury – during movements associated with the abduction and external rotation of the arm. This can happen in a dream, with awkward movements in everyday life. During active sports, the frequency of dislocations increases. The patient resolves such dislocations independently with a certain movement.

The vast majority of patients with this problem have a history of traumatic dislocation of the shoulder, after which immobilization of the upper limb was used. Unfortunately, during the first dislocation, the articular lip is often detached, the main structure that prevents the shoulder head from moving out of the joint cavity.

This injury (Bankart injury) is the main cause of chronic joint instability. The shoulder joint can be compared to a golf ball lying on a stand: in the absence of supporting structures, the ball will fall off the stand, just as the head of the shoulder will dislocate from the joint cavity. With repeated dislocations, the articular cartilage of the shoulder head is erased, and a Hill-Sachs defect forms on its posterior surface. In advanced cases, severe osteoarthritis (arthrosis of the shoulder joint) is formed.

Diagnosis is based on a characteristic anamnesis, patient complaints, and examination data: the patient avoids movements that lead to dislocations, resulting in hypotrophy of the muscles of the upper arm, and symptoms of premonition of dislocation and the front drawer become positive. To clarify the nature of the damage, radiography and MRI are necessary, and if a joint lip with a bone fragment is suspected, computed tomography is performed.

Conservative treatment is futile. Arthroscopic (in certain cases, with an open bone injury to the Bankart) refixation of the cartilaginous lip to the glenoidal cavity of the scapula using biodegradable (self–absorbable) anchors is shown.

The patient's stay in the clinic is limited to the day of the operation. In the postoperative period, the shoulder joint is immobilized for 3 weeks, followed by a gradual development of movements.