Shoulder Stabilisation Surgery
in Rockhampton

What is going on

Shoulder instability is the tendency of the shoulder to dislocate or subluxate (partly slip out) — usually anteriorly, after an initial traumatic dislocation in a younger patient. The first dislocation typically tears the labrum, the cartilage rim around the glenoid, and stretches the anterior capsule; subsequent dislocations occur with progressively less force as the labral and capsular restraints fail. Younger patients (teens and twenties) at the time of first dislocation have the highest risk of recurrence — published rates approach 80–90% in the highest-risk groups. Symptoms range from frank dislocation requiring reduction to a sense of the shoulder "going" with overhead or apprehension positions. MRI arthrogram quantifies the labral and bony damage that guides the surgical choice.

Not sure if this is the right diagnosis? The shoulder pain hub and shoulder injury hub triage the differential by anatomical location.

What the operation involves

Arthroscopic shoulder stabilisation is performed through several small portals around the shoulder. The torn labrum is reattached to the glenoid rim with anchors and high-strength sutures; a capsular shift can be added to tighten the redundant anterior capsule, and a remplissage — filling of a Hill-Sachs bony defect on the humeral head with a tendon transfer — is added where indicated. The procedure typically takes 60 to 90 minutes under regional and general anaesthesia; patients leave hospital the same or next day. For glenoid bone loss too substantial for arthroscopic repair, a Latarjet procedure is offered instead. Full clinical detail is on the education page, and the shoulder instability education page covers the underlying condition.

For full clinical detail — incision, anaesthetic, post-operative instructions and the printable patient handout — see the shoulder stabilisation education page or the shoulder surgery overview.

How this case is handled

Shoulder instability is one of the practice's subspecialty interests — Dr Hirpara's two Brisbane shoulder fellowships at the Brisbane Hand & Upper Limb Clinic and at St Andrew's / Prince Charles Hospitals included extensive instability work, and he has published on the arthroscopic Latarjet technique. Patients are seen for both first-dislocation assessment and for recurrent or revision instability. Shoulder physiotherapy through George Labor in the same suite is integrated into the post-operative pathway.

Fees, Medicare rebates and the surgery-quote process are on the fees page. The case for seeing a fellowship-trained surgeon — and what fellowship training adds — is set out separately. GPs can find the referral pathway, urgency triage and what to include in the letter on the referrer page.

What this operation is billed under

The procedure is covered by the following Medicare Benefits Schedule items. Surgeon, anaesthetist, assistant, hospital and prosthesis fees are quoted separately and in writing before surgery — see the fees page for the practice's quote process and an explanation of why surgical fees follow the Australian Medical Association schedule. Surgery does not proceed without itemised written informed financial consent.

Item 48958 Shoulder stabilisation

Single item covering Bankart repair, capsular shift, remplissage and the various soft-tissue stabilisation options performed in a single operation

Patient questions we hear most

• Will my shoulder dislocate again after stabilisation?

  Recurrence after stabilisation depends mostly on the same factors that cause instability in the first place: age (younger patients have higher rates), bone loss on the glenoid or humeral head, the demands of the patient's sport or work, and whether the surgical construct addressed all the contributing factors. Published recurrence rates after arthroscopic Bankart repair vary widely — rates are higher in young contact-sport athletes than in older patients with first-time dislocations. The Latarjet bone-block alternative offers lower recurrence rates in high-demand patients with bone loss, at the cost of a more invasive operation.

• What's the difference between an arthroscopic stabilisation and a Latarjet?

  Arthroscopic stabilisation is a soft-tissue operation: the torn labrum is reattached and the anterior capsule is tightened. It works well when the labrum is repairable and bone loss is minimal. A Latarjet is a bone-block operation: a piece of the coracoid process is transferred to the front of the glenoid to compensate for bone loss and to add soft-tissue restraint via the conjoint tendon. Latarjet is more invasive but offers lower recurrence rates in high-risk patients. The choice is made from imaging and the patient's demands; Dr Hirpara has published on the arthroscopic Latarjet technique.

• When can I return to contact sport?

  Six to nine months is typical, depending on the construct, the sport's demands, and the post-operative response. Non-contact sport (running, swimming, cycling) is usually possible by four to six months. Contact and overhead-throwing sports — rugby, AFL, water polo, throwing events — require the longest rehabilitation because they impose the most stress on the repair. The post-operative review schedule includes a sport-specific clearance discussion at three and six months.

• What's the success rate of shoulder stabilisation?

  Published outcomes for arthroscopic Bankart repair report shoulder stability in roughly 80–90% of properly selected patients at medium-term follow-up, with high rates of return to pre-injury function. Outcomes are best in patients with classic anterior labral tears, minimal bone loss, careful adherence to post-operative protocol, and a thorough rehabilitation programme. Outcomes are poorer where bone loss has been under-recognised or where the patient returns to high-demand contact sport before the construct is mature; the consult discusses individual risk factors.

• How much does shoulder stabilisation cost? What does Medicare cover?

  Shoulder stabilisation is performed under regional and general anaesthesia, so a separate anaesthetist gap applies on top of the surgeon and hospital fees. The practice quotes the surgical fee in writing before booking — the Medicare item, the rebate and the out-of-pocket gap each shown separately. Dr Hirpara's surgical fees follow the Australian Medical Association schedule, which is higher than the Medicare scheduled fee; the fees page explains why. Surgery does not proceed without itemised written informed financial consent.

• What if my shoulder keeps dislocating after the surgery?

  Recurrent instability after a stabilisation operation is investigated carefully. The MRI is usually repeated to assess the labral repair and to look for bone loss that may have progressed since the original surgery. Where the failure is from progressive bone loss or a failed soft-tissue construct, a revision procedure — most commonly a Latarjet — is considered. The decision is individualised; revision instability surgery is more demanding than primary surgery and is best managed by a surgeon who handles the full instability spectrum.

• Do I need physiotherapy after shoulder stabilisation?

  Yes — shoulder physiotherapy is integrated into the post-operative pathway and is the most important factor in the long-term result. The schedule runs gentle range of motion in the first six weeks (under sling protection), active motion from six weeks, scapular and rotator cuff strengthening from twelve weeks, and sport-specific rehabilitation from four to six months. Shoulder physiotherapy is provided by George Labor in the same suite as Dr Hirpara's rooms. Patients from outside Rockhampton can usually arrange ongoing therapy closer to home after the early intensive sessions.

More general questions about appointments, fees and the practice on the FAQ page.