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Treatment in detailRecurrent shoulder dislocation — Bankart repair & Latarjet
A shoulder that has dislocated more than once has structural damage that will not heal itself — a torn labrum, and often worn bone. Two proven operations restore stability; choosing correctly between them is the real skill.
Why shoulders keep dislocating
The first dislocation tears the labrum — the fibrous rim that deepens the socket — off the bone (the Bankart lesion), and often dents the back of the ball (the Hill-Sachs lesion). The anatomy that prevented dislocation is now damaged, so each recurrence comes easier than the last, and each one wears away more of the socket's bony rim.
The assessment that decides everything
Clinical examination plus MRI maps the soft-tissue damage; a CT scan quantifies the bone loss on both sides of the joint and whether the defects engage each other. This bone arithmetic — not preference, not habit — is what selects the operation.
Arthroscopic Bankart repair
Through keyholes, the torn labrum is reattached to the socket rim with small anchors, restoring the bumper and retensioning the capsule. It is the operation of choice when bone loss is minimal — day-care or one-night surgery, small scars, and a staged rehabilitation back to sport.
The Latarjet procedure
When bone loss is significant, repairing soft tissue to a deficient rim invites failure. The Latarjet transfers a small block of your own bone with its attached tendon to the front of the socket — rebuilding the rim with living bone while the tendon adds a dynamic stabilising sling. For collision athletes, revision situations and worn sockets, it is the durable answer.
Rehabilitation and return
Both operations follow criteria-based rehabilitation: protected early weeks, progressive motion and strengthening, and return to sport — including contact sport — cleared on objective testing, typically around the 5–6 month mark. The protocol is written down and reviewed at every follow-up.
My shoulder dislocated once. Will it happen again?
Age at first dislocation is the strongest predictor: in patients under 25 — especially athletes — recurrence after a first dislocation is very common, because the torn labrum rarely heals back to the bone on its own. Over 40, recurrence is less frequent but rotator cuff tears accompany dislocations more often. Either way, a first dislocation deserves proper assessment, not just a sling.
Can physiotherapy alone stop my shoulder dislocating?
Strengthening helps control but cannot reattach a torn labrum or replace lost socket bone. In a young, active person with recurrent dislocation, rehabilitation alone rarely restores lasting stability — surgery addresses the structural damage, and physiotherapy then completes the result.
How do you decide between Bankart repair and Latarjet?
Bone decides. A CT scan measures how much of the socket rim has worn away and whether the head defect engages it. With minimal bone loss, arthroscopic Bankart repair reattaches the labrum through keyholes. With significant bone loss — or failed previous repair, or high-collision athletes — the Latarjet rebuilds the socket with living bone. Choosing correctly at the first surgery is what prevents a second.
What exactly is the Latarjet procedure?
A small block of your own bone (the coracoid, with its attached tendon) is transferred to the front of the socket and fixed with screws. It works twice over: the bone restores the socket's width, and the transferred tendon acts as a dynamic sling across the joint's weak point. It is among the most reliable operations for recurrent dislocation with bone loss.
When can I return to sport, including contact sport?
Staged and criteria-based: sling for the early weeks, motion then strengthening, sport-specific training from around the fourth month, and return to contact or overhead sport typically around 5–6 months after Latarjet and a similar or slightly longer arc after Bankart — cleared on strength and confidence testing, not the calendar.
What happens if I just keep living with the dislocations?
Each dislocation shaves bone off the socket rim and deepens the dent in the humeral head — bone loss grows, simpler repairs stop being options, and the joint accumulates cartilage damage that shows up later as arthritis. Instability is progressive; treating it early keeps the smaller operation on the table.
A shoulder you can no longer trust?
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