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Shoulder Instability and Recurrent Shoulder Dislocation

A dislocated shoulder by jerking the arm or a blow to the shoulder with simultaneous muscle strain or compression, which causes the arm bone to lose contact with the socket of the shoulder. The more often the shoulder is dislocated, the greater the danger of recurrence, until eventually the shoulder becomes unstable.

Benefits of the operation

Shoulder instability and recurrent shoulder dislocation are treated by shoulder arthroscopy. This technique, which is currently the standard treatment for shoulder disorders and which is constantly improved, makes it possible to access structures that are deep inside the shoulder and are difficult to reach with a complete view from the inside.

This technique is used to treat shoulder problems suffered by patients who generally suffer from pain around the shoulder or who have limited movement that has not improved after medical treatment and physiotherapy which, until now, required far more complex surgery and much longer recovery periods.

Medical-technical description

The injuries caused by dislocation are repaired with the aim of preventing any further episodes. To do this, several 0.5 cm incisions are made around the shoulder and a tiny camera and specific instruments for each type of injury are then inserted. The soft tissues are repaired with sutures and fastened to the bone using latest generation bone attachments coated with an osteoinductor that is reabsorbed by the body or titanium, depending on the case.

About the operation

Shoulder arthroscopy takes place in the operating theatre in a semi-seated position or with the patient lying on his or her side with the arm in question held by a traction-supporting device. The anaesthetist administers locoregional anaesthesia into the brachial plexus (which anaesthetises the nerves that go to the arm) and sedation, for a much more comfortable post-operative period and less pain than with traditional shoulder surgery.

The procedure takes between 30 and 90 minutes. Patients usually spend a night in hospital and are able to go home the following day, at which time they are given a release report setting out the recommendations, treatment to follow and subsequent appointments.

Before the operation

  • The patient goes to the doctor's office for a prior consultation, decisions are taken and the doctor explains the surgery in detail and gives the patient an informed consent.
  • You must take a list of all the medications you usually take (including medicinal plants) to the hospital with you on the day of your surgery.
  • You will have pre-surgical tests consisting of a full blood test, biochemistry, coagulation, chest x-ray and ECG.
  • You must wash the surgical site with antiseptic soap on the night before and on the morning of the surgery.
  • You must not eat or drink for 8 hours before your operation.
  • You must remove all metal objects during the operation (rings, bracelets, earrings, body piercings, etc.).

Post-operative care

  • For the first days after the surgery you may suffer some discomfort or swelling, which will disappear when you take the medicine prescribed by the surgeon.
  • You will need to wear a sling to support your arm when resting for two to four weeks, depending on the injury and surgical findings. You must take off the sling once an hour to bend and stretch your elbow and move your fingers around.
  • Correct rehabilitation is necessary, so on the first few days you must not travel or do any strenuous or violent movements.
  • You must keep the incisions dry until the stitches are removed between five and ten days after the surgery.
  • When the stitches have been removed you will require treatment by a physiotherapist for between four and eight weeks.
  • You will normally be in a condition to drive and do some light activities once your physiotherapy starts. Between two and four months later you can start doing sport again.
  • After release, you should contact us if you have any chest pain or breathing difficulties, swelling or reddening in an arm, sharp pain in the shoulder in question or fever or shivering.

The importance of immediate rehabilitation

  • Correct rehabilitation is essential after an operation of this type. Rehabilitation should start as soon as possible and on the first few days you must not travel or do any strenuous or violent movements. That is why we recommend that before you go back to your country you should spend at least eight days doing rehabilitation at our Casaverde rehabilitation centre.
  • This will help you to improve muscle tone and for the muscles affected by the surgery to gradually become stronger, which will reduce the risk of falling or complications.
  • This will optimise mobility of the joint affected and reduce any pain and/or discomfort that may appear after the surgery.
  • Improves trophism – nourishes the tissues around the operation site and encourages correct healing and closure of the surgical wound.
  • Restores motor skills, giving patients help, guidance and re-educating them adopt walking patterns that will soon have them on the road to recovery.

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