Jock Doc

Many shoulder dislocations need surgery to avoid recurrence

Q. I am a 27-year-old recreational athlete who dislocated my left shoulder skiing two weeks ago. The doctors put it back in place in the emergency room and gave me a sling. When I got back to Miami, I saw an orthopedic surgeon who ordered an MRI. The MRI showed a “rare” type of dislocation called a HAGL. The doctor said without surgery I had a 90 percent chance of the shoulder dislocating again. He said I could use a sling for three weeks and try physical therapy if I did not want surgery. I still like to play contact sports and work out and wonder if I should just go ahead with the surgery. What do you think?

A. Most shoulder dislocations occur with the ball part of the shoulder going out toward the front “anterior.” About 95 percent of the time, anterior dislocations result in tearing the cartilage surrounding the socket known as the labrum.

This type of labral tear is known as a Bankart lesion. Even a Bankart type dislocation has about a 90 percent recurrence rate in your age group. Your type of dislocation is the tearing of the main stabilizing ligament off the humerus bone, known as a “HAGL” lesion, which also has a high recurrence rate.

Whether you fix the shoulder now or decide to rehab it first and see how it does, is a lifestyle decision. Your doctor was correct in giving you options and letting you decide. Most active individuals with shoulder instability ultimately choose the surgical stabilization procedure. Post-op, this requires at least four weeks of a sling, several months of physical therapy and six months away from contact sports.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net.

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