Shoulder Dislocation/Bankart Repair

[thinhorn_AK]

Thanks for all that. Really appreciate the insight. It would be nice to get back into overhead sports. I had to give up badminton, which I loved.

I'm really conflicted. I'd like the shoulder to be more stable and I'd like to move past the nagging fear of a dislocation at an inopportune time. On the other hand, I don't want to have an unnecessary surgery and the associated recovery.

I don’t think 4-6 weeks would work, a friend of mine had it done in October and he’s still not cleared to pick things up with that arm until sometime next month. He was in a sling for at least a couple of months and had a lot of grinding/discomfort. His would pop out when he put his arm overhead and I actually had to reduce it for him while we were out on a jet boat fly fishing. Apparently that time was the worst of all the times, it took us a good 45 minutes to get it done and afterwords, he was just shaking from adrenaline or whatever for the rest of the day. That’s when he decided to get the surgery. Like you, it had been several years since the last time it popped out.

 

[thinhorn_AK]

Dang! Five or six days! That sounds pretty invasive. Mine will be arthroscopic and I'll be released the same day, so yes, sounds like an improvement over your procedure.

I'm hoping with intensive PT I can end up in a better place than I am now, without too much additional range of motion loss (I already have some).

My friends was arthroscopic and he got out of the hospital the same day. My wife removed the stitches for him, I was actually surprised how few stitches there were for such a major repair.

 

[Antares]

His would pop out when he put his arm overhead and I actually had to reduce it for him while we were out on a jet boat fly fishing. Apparently that time was the worst of all the times, it took us a good 45 minutes to get it done and afterwords, he was just shaking from adrenaline or whatever for the rest of the day.

I can relate. Yuck.

My last one was out for almost 3 hours. It took an ER doc and a big, husky tech almost an hour to get it back in. This was after a different doc had tried and given up. When it was finally back in, I asked the ER doc "on a scale of 1-10, how hard was that to reduce" and without hesitations he said it was a 10. So, similar to your friend, mine seems to be getting harder to reduce for some reason. My last one was definitely the worst. I used to reduce mine by myself with minimal drama... seems those days have past.

 

[Fire_9]

I can relate. Yuck.

My last one was out for almost 3 hours. It took an ER doc and a big, husky tech almost an hour to get it back in. This was after a different doc had tried and given up. When it was finally back in, I asked the ER doc "on a scale of 1-10, how hard was that to reduce" and without hesitations he said it was a 10. So, similar to your friend, mine seems to be getting harder to reduce for some reason. My last one was definitely the worst. I used to reduce mine by myself with minimal drama... seems those days have past.

Did they put you out for it? The last two times mine has come out I've had to have it put back in. Both times they just put me out and I was thankful for it. Before surgery I could just relax and let it hang and it would go back in on it's own. No sure if it was the surgery or age that changed that

 

[Antares]

Did they put you out for it? The last two times mine has come out I've had to have it put back in. Both times they just put me out and I was thankful for it. Before surgery I could just relax and let it hang and it would go back in on it's own. No sure if it was the surgery or age that changed that

No, I've never been sedated or under anesthesia for a shoulder reduction. Are you saying you've had two dislocations post surgery?

 

[Fire_9]

No, I've never been sedated or under anesthesia for a shoulder reduction. Are you saying you've had two dislocations post surgery?

Yep. First one was about 10 years post surgery while trying to get a car unstuck in the snow and the other was probably 6-7 years after that while attempting to play ice hockey.

 

[Antares]

Yep. First one was about 10 years post surgery while trying to get a car unstuck in the snow and the other was probably 6-7 years after that while attempting to play ice hockey.

Roughly how many dislocations did you have pre surgery?

 

[Fire_9]

Roughly how many dislocations did you have pre surgery?

Probably 6-7 over a two year period.

 

[doc holiday13]

Your goat hunt is not going to happen if it’s 4 to 6 after your surgery. You have a 3 month minimum recovery. My range of motion is about 10 degrees less especially overhead.

Agree with this. Rehab is like 8 weeks minimum. IF you do your proper rehab and do all the necessary stretching you should get your ROM back. I'm about 18 years post op and still kick myself for not doing all the rehab stuff

 

[ztc92]

I had a different type of shoulder surgery. Mine was a reverse joint replacement done on both shoulders last year.

I hate being a party pooper but there is no way in heck you will be able to shoulder much less fire any big game type round.

Honestly, you will be lucky if you are able to enjoy any shooting sports within a year of the date of your surgery.

I am fairly sure you will need to keep your arm in a sling without any free motion for at least six weeks and then you will do physical therapy for another six weeks just trying to regain your range of motion. After twelve weeks, you will probably start building strength.

I wish you the best of luck with your surgery, do exactly what your surgeon tells you what you can and can't do because if the repair is damaged, you are going to be a sad puppy.

Do not skimp on your physical therapy.

A few thoughts coming with the background of a family doctor with additional training in orthopedics and sports medicine.

Regarding the post above, a reverse shoulder replacement is a very different surgery than a bankart repair. In a reverse shoulder we literally reverse the ball and socket joint. You also lose the rotator cuff (that’s usually the reason to do a reverse vs a normal replacement), so the deltoid muscle is now doing most of the work that was formally handled by the rotator cuff. The pain, recovery period and long term outcome would be quite different between these two very different surgeries.

Other than that, I think most of the advice you’ve received is solid. I would add one thing though…

I understand that in the moment some minor subluxations that don’t cause significant pain or limitations after they resolve are easy to ignore, however there are also long term consequences to consider. When your shoulder subluxes there is the potential for damage to the labrum as well as the cartilage, setting you up for early arthritis. More importantly, when it dislocated you almost certainly will damage the cartilage and may also end up with nerve damage depending on the severity of the dislocation. These long term consequences would have me favoring getting the instability fixed surgically if I was in your shoes.

Best of luck to you, I know shoulder instability can be a very frustrating thing to deal with regardless of how you choose to manage it.

 

[DoctorJJ]

This is non-official medical advice, but you really want a doc that will add a Remplisaage to the Bankart repair (Even if you don’t already have a Hill-Sachs). Lots of data out there showing superiority to Bankart repair alone.

 

[Antares]

A few thoughts coming with the background of a family doctor with additional training in orthopedics and sports medicine.

Regarding the post above, a reverse shoulder replacement is a very different surgery than a bankart repair. In a reverse shoulder we literally reverse the ball and socket joint. You also lose the rotator cuff (that’s usually the reason to do a reverse vs a normal replacement), so the deltoid muscle is now doing most of the work that was formally handled by the rotator cuff. The pain, recovery period and long term outcome would be quite different between these two very different surgeries.

Other than that, I think most of the advice you’ve received is solid. I would add one thing though…

I understand that in the moment some minor subluxations that don’t cause significant pain or limitations after they resolve are easy to ignore, however there are also long term consequences to consider. When your shoulder subluxes there is the potential for damage to the labrum as well as the cartilage, setting you up for early arthritis. More importantly, when it dislocated you almost certainly will damage the cartilage and may also end up with nerve damage depending on the severity of the dislocation. These long term consequences would have me favoring getting the instability fixed surgically if I was in your shoes.

Best of luck to you, I know shoulder instability can be a very frustrating thing to deal with regardless of how you choose to manage it.

I really, really appreciate your thoughts and perspective. Thank you very much for taking the time to write that up.

This is non-official medical advice, but you really want a doc that will add a Remplisaage to the Bankart repair (Even if you don’t already have a Hill-Sachs). Lots of data out there showing superiority to Bankart repair alone.

I do have a Hill-Sachs and I will likely have a Remplisaage done at the same time, but it will depend on what the surgeon sees when he get in there. That's my understanding at this point.

 

[Antares]

I scheduled myself a pre-surgery PT session. I want to get some stretches and exercises going so the shoulder is nice and loose for the surgery (pun intended). I also want to establish a ROM baseline so I can have a goal to work towards post op.

 

[Amos Keeto]

Who here has had shoulder surgery to address joint instability?

After multiple dislocations, I'm scheduled for a Bankart repair to my dominant shoulder.

Anyone had a Bankart repair? What was recovery like? How was your range of motion affected? Did it resolve your dislocation issues?

I have a mountain goat hunt tentatively planned 4-6 weeks post op. I'm guessing that's a bad idea, but "bad idea" is pretty much my middle name.

Thanks for any insight!

August 19, 2019......

Dislocated my right shoulder playing high school football back in 1967.
Over the years, it seemed to dislocate easily, again and again over the decades. I always had to be wary or I'd end up on the ground, writhing in pain until I could get it to pop back in place.
I rescued a Remington "Sportsman" 16 gauge from a pawn shop. It's a beauty!
Summer of 2019, my wife alerts me to a skunk running across our yard. I grab my beloved Sportsman and give chase.
I caught up, but when the shotgun went off, the pain in my shoulder was so severe, I went to my knees and nearly dropped the shotgun.....and missed the skunk.
Went back in the house, sat down in the living room and called McBride Ortho clinic in OKC!

Once you damage a joint, it begins to deteriorate.
I had allowed my shoulder to go so long, it was bone on bone and they wouldn't even offer an injection! Just replace it!

You can have that shoulder fixed, repaired, cleaned up, tightened or rebuilt. It will eventually have to be "re-" whatever you choose!
Unwanted advice: have it replaced! Once and done.

 

[Amos Keeto]

WOW!!!
Should have read a bit more!!!

Here's some concessions I had to make.
Rifles:
My favorite rifle is a Ruger No.1 in .270 Win.
Either shoot left handed, or give up fixed actions.
I went with an AR in 6.8mm Rem SPC. Shooting it enough to sight in and hunt is comfortable.
Shotguns:
I had to give up my Win M12's and Rem 870. Fixed actions.
The old antique Rem Sportsman was sent to Briley in Houston and tubed. I wouldn't want to spend an afternoon shooting rounds of trap or skeet, but for a little turkey and squirrel hunting, recoil is quite acceptable.
...or learn to shoot left handed.
Handguns:
Pretty much just steer clear of short barreled magnums!
Weight restriction:
Doc says limit lifts to 25 pounds.....but I'm 74 years old. Twenty five pounds IS about my limit!
Recovery:
Doc restricted me to one year before shouldering and shooting a long gun.

Worked with a guy once who saw himself as some sort of Kung Fu champion.
EVERYtime his instructor showed him how to throw a kick or punch, he would immediately say, "I can't because.....!" and give some off the wall excuse.
Exasperated, the instructor told him, "Stop telling me why you can't and start figuring out how you can!"
Long story short.
As you recover, you'll figure out more restrictions. When you hit that wall, take some time and figure out a "work-around"!

I can do everything I've always done. It just takes me longer!

 

[Amos Keeto]

Who here has had shoulder surgery to address joint instability?

After multiple dislocations, I'm scheduled for a Bankart repair to my dominant shoulder.

Anyone had a Bankart repair? What was recovery like? How was your range of motion affected? Did it resolve your dislocation issues?

I have a mountain goat hunt tentatively planned 4-6 weeks post op. I'm guessing that's a bad idea, but "bad idea" is pretty much my middle name.

Thanks for any insight!

That all depends.
First, after surgery, PT won't start for 3 to 6 weeks. It's got to heal before PT.
PT takes about 4 to 6 weeks.
"IF" you can learn to shoot from your other shoulder, you shouldn't have a problem.
During your recovery, you really DON'T want to take on 25 pounds with that shoulder!
After surgery, unaware of just how much pain I had been in, I slept like a baby that night.
The surgeon prescribed pain killers to use "as needed" during recovery. The therapist suggested taking a dose prior to therapy.
I took ONE pill because a nurse insisted I take one before the 135 mile trip home.
I never took another pain killer!
My ROM isn't what God gave me, but I've got a lot more now than I did before surgery!
Another of my problems was that the shoulder wouldn't allow me a full night's sleep. I'm a restless sleeper. If I moved that shoulder wrong while I was sleeping, searing pain would wake me. It would wake me no less than 4 or 5 times a night.
At this point, I haven't dislocated the implant. My doctor tells me that's something I "REALLY" don't want to do. If I mess this one up, the only repair will be the reverse implant. Ball on the shoulder, socket on the humerus. You don't want that!
I did trip on some hog wire about 4 months post surgery and landed on that shoulder! Scared me to death! It was sore for about 2 weeks, but x-rays showed no displacement or damage. WHEW!
Suggestion:
Research your surgeon well. Their abilities and knowledge are key.

 

[DoctorJJ]

Do NOT ask for or opt for a total replacement unless it’s your last option. If you’re young and healthy and still have decent cartilage, which I’m assuming you do since your surgeon suggested Bankart, jumping ahead to a total would be foolish. Most rehab starts within 1-2 weeks, even with a repair. It won’t actually be fully healed for 12 weeks. The therapy is limited and you let the repair get a bit of a head start on healing but you don’t wait til it’s healed to start PT.

 

[Antares]

We are drifting a little off topic. My initial question was whether or not to proceed with a labrum repair; there is no discussion of a replacement. My shooting is unaffected by my shoulder instability because the buttpad is inboard of the joint. Thanks for your thoughts though. I appreciate it.

 

[thinhorn_AK]

We are drifting a little off topic. My initial question was whether or not to proceed with a labrum repair; there is no discussion of a replacement. My shooting is unaffected by my shoulder instability because the buttpad is inboard of the joint. Thanks for your thoughts though. I appreciate it.

My friend who just had the surgery has been shooting his 223 since ~ 3 weeks after the surgery. He was in town last weekend for a check up and bought a new 300 win mag. All that to say, you’ll have no issues shooting moving forward.

 

[Marble]

Who here has had shoulder surgery to address joint instability?

After multiple dislocations, I'm scheduled for a Bankart repair to my dominant shoulder.

Anyone had a Bankart repair? What was recovery like? How was your range of motion affected? Did it resolve your dislocation issues?

I have a mountain goat hunt tentatively planned 4-6 weeks post op. I'm guessing that's a bad idea, but "bad idea" is pretty much my middle name.

Thanks for any insight!

I didn't have the Bankart repair, but I had the labrum reattached and sewn back together, then secured with anchors. It was torn in half and I had to hold my arm on the socket for a few months until surgery. I would not advise you go on the goat hunt. Very high likelihood of reinjuring. 6 months post-op, I was doing great. Lifting weights, shooting my bow, etc. I ended up getting tripped playing softball and ripped an anchor out.

For me I had more muscle strength then the repair had at the time. It felt better immediately post surgery and got better overtime. But with surgeries like this, it is usually 1 year before you will be 100%.

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