Is Surgery Necessary for Recurrent Shoulder Dislocation?

What does “recurrent shoulder dislocation” mean?

The shoulder is one of the most mobile joints in the body. This mobility is helpful in daily life, but it also makes the shoulder more vulnerable to dislocation after trauma. Recurrent shoulder dislocation (shoulder instability) means the shoulder dislocates again after the first event, or it repeatedly feels like it is about to “slip out.”

During the first dislocation, structures that keep the shoulder stable can be injured—most commonly the labrum and the joint capsule/ligaments. In some cases, repeated episodes may also lead to bone loss. If these structures do not heal in a stable way, the shoulder can remain “loose” and the risk of recurrence increases.

Is surgery always necessary?

No. Surgery is not automatically required for everyone. However, in certain patient groups, surgery becomes the most reliable long-term solution. The decision depends mainly on: age, activity level, the type of damage in the shoulder, and how the instability behaves.

1) Age

Younger patients (especially under 20 and early 20s) tend to have a higher risk of recurrence after a first dislocation. As age increases, some patients have a better chance of remaining stable with non-operative care.

2) Activity level (sport / work / lifestyle)

Contact sports and jobs or activities involving overhead use of the arm place the shoulder under higher demand. In these groups, a recurrent dislocation is not just painful—it can affect performance and safety—so surgical stabilisation may be considered earlier.

3) The type of damage (soft tissue vs bone loss)

Some patients primarily have soft-tissue injuries (labrum/capsule). Others develop structural problems such as bone loss. The more bone loss there is, the harder it becomes for physiotherapy alone to provide a durable solution.

4) How many times has it happened—and how easily?

• A second dislocation often indicates established instability.
• Three or more dislocations usually point to a chronic problem where surgery is frequently the most effective option.
• If it happens with very small movements, or feels like it will “pop out,” this is also an important warning sign.

When does non-surgical treatment make sense?

Non-operative care is often reasonable after a first dislocation in lower-risk patients—typically those who are older, not involved in contact sports, and without signs of significant structural damage. A key requirement is good adherence to rehabilitation.

Physiotherapy aims to strengthen the rotator cuff and shoulder blade muscles to provide “dynamic stability.” However, if structural damage is significant (e.g., labral tear with instability or bone loss), strengthening alone may not prevent recurrence.

When is surgery more likely to be the right choice?

• A second dislocation (especially in young/active patients)
• Three or more dislocations
• High-demand sports or work where stability is essential
• Frequent “slipping” episodes (subluxation)
• Imaging showing labral injury and/or bone loss
• Ongoing fear and loss of confidence despite rehabilitation

The goal is not to “wait for one more dislocation,” but to choose the right treatment at the right time to protect long-term shoulder health.

Surgical options (simple overview)

Arthroscopic Bankart Repair (keyhole stabilisation)

This procedure repairs the torn labrum and tightens the capsule using arthroscopy (small incisions and a camera). It is commonly recommended when instability is mainly due to soft-tissue injury and there is no major bone loss.

Latarjet Procedure (bone-augmentation stabilisation)

For significant bone loss, multiple recurrences, or high-risk contact sports, the Latarjet procedure can provide stronger stability. It adds bone support at the front of the socket and improves stability in demanding situations.

What is recovery like?

Recovery is step-by-step: initial protection in a sling, then gradual range-of-motion work, followed by strengthening, and finally a controlled return to sport. The quality of the outcome depends not only on the operation, but also on rehabilitation discipline.

Conclusion

The correct answer to “Do I need surgery?” is personal. It depends on your age, activity demands, the type of injury, and how often the shoulder is slipping out. If instability is recurring, timely assessment and a tailored plan based on examination and imaging is the most sensible approach.