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Shoulder — Instability and labrum

Open shoulder stabilization for shoulder dislocation

The shoulder is a ball-and-socket joint, stabilized by the labrum, which runs around the socket like a rubber O-ring. A traumatic hit in a contact sport such as football or ice hockey can dislocate the ball from the socket, detaching the labrum and stretching the capsule.

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When open stabilization is used instead of arthroscopic

In most patients with a labral tear — a Bankart lesion — the shoulder is stabilized arthroscopically. In select contact athletes, however, an open stabilization is undertaken because it has been shown to have a lower rate of re-dislocation: roughly 4%, against about 6–16% for arthroscopic stabilization.

How the operation is performed

An incision is made at the front of the shoulder and the labrum is reattached to the socket using suture anchors. In addition, the stretched shoulder capsule is precisely tightened in a procedure called a capsular shift, which can be done more accurately open than arthroscopically.

Dr. Seneviratne has considerable experience with open shoulder stabilization. He assesses each patient individually and customizes treatment based on a range of factors.

Shoulder video

Open shoulder stabilization in a pro football player

Shoulder dislocations in contact athletes may need open shoulder stabilization in select cases, because of the magnitude of the injury. Open stabilization in contact athletes has been shown to have a lower rate of repeat dislocation. This patient underwent open shoulder stabilization and made an excellent recovery in six months.

Endoscopic subpectoral biceps tenodesis

The procedure Dr. Seneviratne pioneered, performed through a 7mm incision with an endoscope rather than the traditional open approach.

The Latarjet procedure for recurrent shoulder dislocations

A brief overview of the Latarjet procedure for patients with recurrent shoulder instability.

PRP preparation using the Emcyte system

How platelet rich plasma is prepared in the office before injection.

Treatment of shoulder separation (AC joint separation)

A patient who had a shoulder separation underwent AC joint reconstruction, also called CC ligament reconstruction. Three months later he has excellent function, with correction of the separated AC joint.

Stem cells and rotator cuff healing, featured on CBS News

Dr. Seneviratne featured on CBS News for his work on the use of stem cells to enhance rotator cuff healing. See how the treatment worked for a patient who underwent rotator cuff repair in both shoulders.

About this treatment. Stem cell therapy for tendon healing is an area of active research. This clip describes one patient's experience and is not a statement of established outcome. Discuss what is and is not known for your own case at consultation.
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