Recurrent Shoulder Dislocation

The shoulder is the most mobile joint in the body, which also makes it the most vulnerable to dislocation.
When a shoulder gets dislocated repeatedly, the condition is known as recurrent shoulder dislocation.

In most cases, the first dislocation causes a tear in the shoulder labrum — a ring-like structure that helps keep the shoulder ball inside the socket. If this tear does not heal properly, the shoulder becomes unstable and may slip out again, even with very minimal force.

The specific injury to the labrum that leads to repeated dislocations is called a Bankart’s lesion. To stop further dislocations, this lesion needs to be repaired surgically, a procedure known as Bankart’s repair.

Clinical features

Patients with recurrent shoulder dislocation usually describe:

• A history of multiple shoulder dislocations
• Episodes happening even during sleep or normal daily activities
• Minimal or no pain during dislocation in some cases
• Ability to “put the shoulder back in place” by themselves
• Dislocation most commonly occurring in abduction and external rotation (arm lifted outward and turned externally)

On physical examination, the Apprehension Test is typically positive, indicating that the patient feels the shoulder is about to dislocate in the vulnerable position.

Investigations

The diagnosis is supported by clinical examination and confirmed with MRI.

Typical MRI findings include:

• Bankart’s lesion – tear of the labrum
• Hill-Sachs lesion – indentation injury to the humeral head caused during dislocation

Sometimes the labrum tear is associated with a fragment of bone that separates from the socket. This is called a Bony Bankart’s lesion.

Identifying whether there is bone loss in the glenoid cavity (shoulder socket) is key to choosing the right surgical treatment.

Treatment

Recurrent shoulder dislocation does not improve permanently with medicines or physiotherapy alone.
Surgery is the only definitive treatment to restore stability.

• Ultrasound guided PRP injection
  Performed when the tear is very mild and pain is not getting relieved.
• Arthroscopic Bankart Repair
  Performed when there is no significant bone loss. The torn labrum is stitched back and secured using anchors to restore shoulder stability.
• Bony Procedures
  If there is considerable loss of glenoid bone, soft-tissue repair alone may not be sufficient. In such cases, bone-augmentation procedures are performed to rebuild the shoulder socket and prevent redislocation.

The goal of surgery is to repair structural damage, restore stability, and allow the patient to return to normal activities — including sports — with confidence.

Key Takeaway

Recurrent shoulder dislocation is caused by structural damage in the shoulder, most commonly a Bankart’s lesion. Repeated episodes won’t stop on their own and may progressively worsen. Timely surgical repair prevents further dislocations, protects the joint from long-term damage, and helps patients regain full and stable shoulder function.