Treating First-Time Traumatic Shoulder Dislocation: A Q&A With Dr. Michael Saper

While some pediatric and adolescent patients with shoulder instability will improve with physical therapy, research has shown that patients with a traumatic first-time dislocation may benefit from early surgery.

We asked pediatric orthopedic surgeon and sports medicine specialist Dr. Michael Saper to describe how patients with a shoulder dislocation benefit from being treated at Seattle Children’s.

Should patients with a first-time traumatic shoulder dislocation have surgery?

Research has shown that in adolescent patients, having stabilizing surgery after a traumatic first-time dislocation is more cost-effective and leads to lower recurrence, higher function and less shoulder arthritis. Furthermore, repeated dislocations can make surgical stabilization more difficult, more invasive and less successful.

After a shoulder dislocation, patients and their families will benefit from a consultation with the Children’s surgical sports medicine team to discuss this option. However, surgical decision making is individualized to each patient, and not every patient is an appropriate candidate for arthroscopic surgery.

What makes Children’s approach to this surgery unique?

Our expertise. Adolescent athletes represent the most challenging group of patients with the highest risk of recurrence. At Children’s we exclusively treat and research this high-risk population.

Having trained under renowned orthopedic surgeon, Dr. James Andrews at the Andrews Institute, I perform the majority of stabilization surgeries arthroscopically using cutting-edge, minimally invasive techniques that cause less pain and reduce recovery time, allowing for an early return to sport and play.

Furthermore, we use techniques to minimize postoperative pain and narcotic use, which is getting a lot of national attention. As the leader in pediatric regional anesthesia in the country, our anesthesiologists use outpatient nerve catheters for ambulatory shoulder surgery. Research in our patients has shown that this method provides excellent intraoperative and early postoperative analgesia during and following shoulder surgery and minimizes perioperative opioid use. This approach limits potential complications, including those associated with opioid dependence and abuse.

Finally, we have exceptional physical therapists who administer extensive “return to sport” tests to assess strength and functional recovery after surgery and help guide decision making for safe return to sport activities. These objective tests minimize injury, recurrence, and postsurgical complications.

Learn how to Refer a Patient to Orthopedics and Sports Medicine.