--- title: "Shoulder Dislocation & Instability | Dr. Avi Chezar" description: "Shoulder dislocation and recurrent instability: why the shoulder keeps dislocating, how it is diagnosed, and when Bankart repair or Latarjet is used." canonical: https://www.catef4u.com/en/shoulder-instability translation-of: https://www.catef4u.com/shoulder-instability last-updated: 2026-11-03 language: en source: catef4u.com --- # Shoulder Dislocation, Recurrent Dislocations & Instability > Shoulder dislocation and recurrent instability: why the shoulder keeps dislocating, how it is diagnosed, and when Bankart repair or Latarjet is used. Diagnosis, causes and treatment options ## In brief Summarized and reviewed by Dr. Avi Chezar, shoulder surgery specialist, Assuta Haifa and RMC Afula. **What it is:** During a first dislocation, a tear of the labrum (Bankart lesion) usually occurs – a tear that does not heal on its own and damages the stabilizing mechanism. With recurrent dislocations, wear of the anterior glenoid may develop. **Symptoms:** Recurrent dislocations – the more episodes there are, the easier the trigger for the next dislocation becomes, to the point of dislocating during sleep. Shoulder apprehension: a feeling that "the shoulder is about to come out of place", which prevents certain movements. **Diagnosis:** CT arthrogram or MRI arthrogram with contrast injection to assess the associated injuries. With clear recurrent dislocations, a plain CT can be enough to plan surgery. **Treatment:** After a single episode, physiotherapy can be tried – but it does not heal the tear. Recurrent dislocations require surgery: arthroscopic repair (Bankart) or a Latarjet procedure when there is a bone defect, with 4–6 months of rehabilitation. ## What are recurrent dislocations or shoulder instability? This usually occurs in young people under age 40. The first dislocation is usually the result of an injury or a fall. The more dislocation episodes there are, the milder the triggering event becomes, to the point of dislocating during sleep or with a simple movement. Instability shows itself most obviously as recurrent dislocations, but also as difficulty using the arm, mainly in a position with the arm raised and reaching backwards, similar to a throwing movement or a tennis stroke. The difficulty with function comes from a feeling of apprehension. **Shoulder apprehension** is the feeling that "the shoulder is about to come out of place" during a particular movement. The patient avoids the problematic position or movement, and sometimes avoids activities such as sport or physical work for fear of another dislocation. ## What causes the instability? During the first dislocation, a **tear of the ligaments that stabilize the shoulder** occurs. This injury is called a **Bankart lesion** – a tear of a structure called the **labrum**. The tear **does not heal on its own**; because of the tear the shoulder's stabilizing mechanism is damaged, and any event can cause a dislocation. With recurrent dislocations, **wear of the bone** may develop, mainly of the anterior glenoid. This can be diagnosed with a **CT scan of the shoulder**. Another bony finding in a dislocation is a **compression injury of the back of the humeral head**, caused by the head of the humerus pressing against the glenoid. This finding is called a **Hill-Sachs "fracture"**, but it is not really a true fracture and does not need to be treated like one. ## How is instability diagnosed? - **History** – the patient reports repeated episodes of the joint coming out of place. - When there are no clear dislocation episodes, the diagnosis is mainly **clinical**, based on typical findings on physical examination, including excessive mobility and signs of apprehension. - To assess the associated injuries, a **CT arthrogram** or **MRI arthrogram** (with contrast injection) is needed; with recurrent dislocations and clear instability, a **plain CT** can be enough for assessment and pre-operative planning. This imaging is essential for assessing the **extent of bone damage** in the shoulder and for choosing the appropriate type of surgery. ## How is instability treated? ### Conservative treatment After a single dislocation, or a repeat dislocation after several years, treatment with **physiotherapy** can be tried. It is important to understand that physiotherapy **does not heal the tear**, but it may allow a return to normal activity. Recurrent dislocations and signs of shoulder instability require surgery to stabilize the shoulder. ### Surgical treatment **I usually perform one of two procedures:** 1. **[Arthroscopic repair of the capsular tear](https://www.catef4u.com/en/bankart-repair) (Arthroscopic Bankart Repair)** 2. **Arthroscopic stabilization by transferring the coracoid bone – the [Latarjet procedure](https://www.catef4u.com/en/latarjet-procedure)** The operation can also be done as an open operation, but my preference is to perform it arthroscopically. The advantages of arthroscopic Latarjet (referring specifically to the Latarjet procedure): good, precise visualization of the surgical area, more accurate positioning of the bone and identification of structures at risk (for example nerves). In addition, I can identify and treat other problems in the shoulder in the same operation; damage to the surrounding tissues is significantly lower and the risk of infection is significantly lower. For these reasons, rehabilitation after surgery is easier and safer for the patient. I have experience of more than 2,000 operations using this method, with very high success rates and a very low complication rate. ## How is the type of surgery chosen? The choice depends on: the extent of bone damage, the duration of symptoms, the patient's level of activity, the degree of flexibility, age and previous operations. **For further reading** on the different operations, follow the relevant link on the site: [Bankart repair](https://www.catef4u.com/en/bankart-repair) · [Latarjet procedure](https://www.catef4u.com/en/latarjet-procedure). ## What happens after surgery? After surgery, a rehabilitation period of **4–6 months** is needed before returning to full activity. Rehabilitation includes physiotherapy both at a clinic and on your own at home. The exact instructions follow a protocol set by the operating surgeon. ## Does the shoulder return to normal after surgery? The goal of the operation is to allow a return to full activity **without further dislocations**. To ensure the best possible result, it is important to carry out a full pre-operative assessment and to choose the most appropriate type of surgery. ## Explanatory video [Video: Treating recurrent dislocations and shoulder instability (in Hebrew)](https://www.youtube.com/watch?v=bxBSgJRiQsk) **Treating recurrent dislocations and shoulder instability** – An explanation of the treatment options for shoulder instability: from physiotherapy to arthroscopic surgery to repair the labrum and prevent recurrent dislocations. The video is in Hebrew. ## Frequently asked questions about shoulder dislocation and instability ### What causes shoulder instability after a first dislocation? During the first dislocation, a tear of the ligaments that stabilize the shoulder occurs. This injury is called a Bankart lesion – a tear of a structure called the labrum. The tear does not heal on its own; because of this the stabilizing mechanism is damaged, and any event can cause a dislocation. With recurrent dislocations, wear of the bone of the anterior glenoid may also develop. ### How do you choose between Bankart repair and a Latarjet procedure? The choice depends on the extent of bone damage, the duration of symptoms, the patient's level of activity, the degree of flexibility, age and previous operations. The pre-operative assessment is done with a CT arthrogram, an MRI arthrogram, or a plain CT in cases of recurrent dislocations and clear instability – to assess the extent of bone damage and choose the appropriate type of surgery. ### How long is rehabilitation after shoulder stabilization surgery? After surgery, a rehabilitation period of 4–6 months is needed before returning to full activity. Rehabilitation includes physiotherapy both at a clinic and on your own at home, according to a protocol set by the operating surgeon. ### Can the shoulder dislocate again after surgery? The goal of the operation is to allow a return to full activity without further dislocations. To ensure the best possible result, it is important to carry out a full pre-operative assessment and to choose the most appropriate type of surgery. Dr. Chezar has experience of more than 2,000 operations using this method, with very high success rates and a very low complication rate. ## Further reading from leading medical sources - [Chronic Shoulder Instability — OrthoInfo (AAOS)](https://orthoinfo.aaos.org/en/diseases--conditions/chronic-shoulder-instability/) – Shoulder instability and recurrent dislocations – diagnosis and treatment --- Canonical HTML: https://www.catef4u.com/en/shoulder-instability Hebrew original: https://www.catef4u.com/shoulder-instability Site index for agents: https://www.catef4u.com/llms.txt _This Markdown is the text-only variant of the page above, served for `Accept: text/markdown`. It is an English translation of Dr. Avi Chezar's Hebrew page. Medical information here is general and does not replace a personal consultation._