Shoulder Dislocations in Athletes: Why One Surgery Isn't Always Enough (And How We Fix That)

Picture this: A linebacker drives into your shoulder during a tackle. A wrestler throws you hard. You go up for a rebound and land awkwardly with your arm extended.

Pop.

Your shoulder dislocates—and in that instant, everything changes.

For adolescent athletes, a first-time shoulder dislocation isn't just painful. It's the beginning of a frustrating cycle that, if not properly addressed, can sideline you again and again.

Here's what most young athletes and parents don't realize: the way we repair your shoulder the FIRST time can make or break your athletic future.

Let's talk about what really happens when your shoulder dislocates—and how modern surgery is changing the game.

What Actually Breaks When Your Shoulder Dislocates

When your shoulder pops out of the socket, it's not just a temporary misalignment. Real structural damage occurs:

1. The labrum tears (the cartilage "bumper" that stabilizes the ball-and-socket joint)

2. The capsule stretches or tears (the ligaments that hold everything together)

3. A Hill-Sachs lesion often forms (a dent in the head of the humerus bone from impact)

This trifecta of damage is called a labral-capsular complex disruption. And if you're an adolescent athlete, your body's natural healing response alone won't cut it.

The Problem: Traditional Repairs Aren't Enough for High-Risk Athletes

Foshoulder-dislocations-in-athletes-why-one-surgery-isn-t-always-enough-and-how-we-fix-thatr years, the standard treatment has been arthroscopic labral repair—reattaching the torn labrum and tightening the capsule. It's minimally invasive, proven, and effective.

Except when it's not.

Studies show that in adolescent athletes, arthroscopic labral repair alone has a recurrent instability rate of approximately 15%. That means roughly 1 in 7 young athletes will dislocate again after surgery.

For contact sport athletes—football players, wrestlers, MMA fighters, hockey and lacrosse players, basketball competitors—that number can be even higher.

The Missing Piece: The Remplissage Procedure

Here's where cutting-edge shoulder surgery separates adequate results from elite outcomes.

When we combine a standard arthroscopic labral repair with a Remplissage procedure, something remarkable happens:

Recurrent instability rates drop to nearly 0%.

Let me say that again. Nearly zero.

So What Is a Remplissage?

The term "remplissage" is French for "filling in." And that's exactly what it does.

Remember that Hill-Sachs lesion—the dent in your upper arm bone? When your shoulder is in certain positions (like throwing a punch, making a tackle, or going for a layup), that dent can engage with the socket rim and cause your shoulder to pop out again.

During a Remplissage procedure, we sew the infraspinatus tendon into the Hill-Sachs defect, effectively:

• Filling in the dent

• Creating a biological "backstop" that prevents engagement

• Adding an extra layer of stability to the shoulder

Think of it as plugging the leak before it becomes a flood.

Who Needs This? Contact and Combat Athletes

Not every shoulder dislocation requires a Remplissage. But if you're an adolescent athlete in a contact or combat sport, the stakes are higher—and so is your risk.

High-risk sports include:

Football (tackles, collisions, arm bars) 

MMA (grappling, striking, submissions) 

Wrestling (throws, pins, explosive movement) 

Hockey (checking, falls, boards contact) 

Lacrosse (stick checks, body contact) 

Basketball (physical play under the rim, falls)

If you're competing at a high level in any of these sports, a labral repair + Remplissage isn't just an option—it's your best insurance policy against another dislocation ending your season (or career).

The Cost of Getting It Wrong the First Time

Here's the harsh reality: revision shoulder surgery is harder than primary surgery.

If you go through a labral repair alone and dislocate again six months later, now you're facing:

• More scar tissue

• Weaker tissue quality

• A longer, more complicated recovery

• Increased risk of arthritis down the road

Some athletes end up needing three or four surgeries over their career because the problem was never fully addressed the first time.

We don't want that for you.

The Complete Solution: Labral Repair + Remplissage

When we address both the labral-capsular damage AND the Hill-Sachs lesion in a single surgery, we're not just fixing what's broken—we're preventing future injury.

The results speak for themselves:

• Recurrent instability: nearly 0%

• Same recovery timeline as labral repair alone

• Return to contact sports with confidence

• Long-term shoulder health protected

This is comprehensive, modern shoulder stabilization surgery. Not just repairing the tear—rebuilding the structure to withstand the demands of elite competition.

What This Means for You

If you've dislocated your shoulder—or your son or daughter has—the conversation with your surgeon should include these questions:

• Is there a Hill-Sachs lesion?

• Am I a candidate for Remplissage?

• What's my risk of re-dislocation with labral repair alone?

• Do you routinely perform this procedure for contact athletes?

Don't settle for a one-size-fits-all approach. Your sport, your age, and your goals matter.

Bottom Line

A shoulder dislocation in an adolescent athlete isn't just an injury—it's a career decision point.

The combination of arthroscopic labral repair + Remplissage procedure represents the gold standard for preventing recurrent instability in high-risk athletes. It's the difference between getting back in the game and spending your season on the sideline wondering "what if?"

For contact and combat sport athletes, this isn't overkill. It's smart medicine.

Dealing with a shoulder dislocation or worried about instability? Let's create a surgical plan that gets you back to your sport—and keeps you there. Book a consultation with Dr. Romanelli to discuss your best path forward.