Shoulder Instability Surgery

When your child’s shoulder keeps slipping out of place even after physical therapy, it can be hard to know what to do next. At CHOC, part of Rady Children’s Health, our pediatric orthopedic specialists bring unmatched expertise to caring for children with shoulder instability, offering the highest level of evaluation, guidance, and surgical precision for growing joints.

We understand how stressful it can feel to face the possibility of surgery. Our goal is to provide clear information, steady guidance, and compassionate care, so your child can return to the activities that bring them joy and confidence. 

Minimally invasive arthroscopic shoulder surgery at CHOC 

Every child brings their own story, activity level and goals into the exam room. Our orthopedic surgeons take all of this into account when choosing the safest and most effective way to repair an unstable shoulder. However, because kids and teens are still growing, we prioritize techniques that protect their growing bodies.  

For most patients, this means using a minimally invasive procedure called arthroscopic shoulder surgery. This approach allows our surgeons to repair the exact tissues damaged during a shoulder instability event through just a few small incisions.  

When is shoulder stabilization surgery needed? 

Surgery is rarely the first step for shoulder instability. At CHOC, we begin with nonsurgical care whenever possible, using treatments such as physical therapy, bracing, and activity modification to strengthen the muscles surrounding the shoulder.  

However, when the ligament or labral tear is too severe, strengthening the surrounding muscles is no longer enough to keep the shoulder stable. In these cases, surgery may be needed to repair the torn tissue, rebuild the ligaments or retighten the joint to prevent repeated instability.  

Your care team may recommend surgery if: 

• The shoulder continues to dislocate or feel unstable after physical therapy 
• Imaging shows a tear in the labrum (Bankart tear) or shoulder ligaments 
• The injury happened during a fall or contact sport 
• Your child has naturally loose ligaments or a shallow shoulder socket 

Our team of pediatric experts can help you understand when surgery may be helpful and what it may improve for your child. 

How does arthroscopic surgery work? 

Using a tiny camera inserted into the joint, our surgeons get a precise view of the tear without disrupting nearby tissues. Specialized instruments then let them gently reattach the torn labrum (the ring of cartilage that helps hold the shoulder in place) to the bone with small implants. This restores the shoulder’s natural “seatbelt” of ligaments, tightens the joint and helps prevent future dislocations. 

Why is arthroscopy preferred for most kids and teens: 

• Protects growing bones with minimal disruption 
• Allows precise repair of the most common instability injury 
• Results in smaller incisions, less scarring and typically less pain 
• Supports a smoother recovery and return to regular activity 

When is open shoulder surgery needed?  

While arthroscopy works well for most children, some injuries require a more detailed repair through open shoulder surgery. This approach involves a larger incision but can provide strong, long-lasting results for children who need a more extensive reconstruction. Our team works closely with families to explain all options and choose the approach that best supports their child’s long-term health and goals. 

Open shoulder stabilization may be recommended when: 

• The injury involves significant bone loss 
• The shoulder has severe or complex instability 
• A previous repair did not fully resolve the issue 
• Surgeons need full access to the joint to rebuild stability 

What to expect: Shoulder instability surgery at CHOC

We know any surgery can feel intimidating for children and parents. Our team supports your family through every step with compassionate guidance and child-focused care that makes the experience easier to navigate. 

When will my child be able to return to activity after shoulder surgery? 

While each child heals differently, most soft tissues follow a predictable recovery pattern. The shoulder needs about 12 to 16 weeks to develop strong initial healing and then several more months to build strength and stability. For this reason, the earliest return to sports is typically around 6 months after surgery. 

A typical recovery timeline looks like: 

• Weeks 1 to 6: Rest and sling use. Protecting the repair is the priority. Your child wears a sling while tissues begin to heal. 

• Weeks 6 to 12: Gentle physical therapy to regain motion. Therapists guide slow, safe movements to restore flexibility without stressing the repair. 

• Months 3 to 6: Strength building and return to daily activities. The body enters the key healing phase (12–16 weeks). Physical therapy focuses on building strength and improving joint mechanics. 

• Months 6 to 9: Return to sports after surgeon clearance. Once we restore strength, motion and stability— and the surgeon confirms the shoulder is ready — children can begin a gradual return to sports. 

Our team will tailor this plan specifically for your child and guide you through each step of their healing journey. 

Connect with a CHOC Orthopedic Specialist 

If your child’s shoulder continues to dislocate or feel unstable, our pediatric orthopedic team is here to help. We can explain your child’s condition, review treatment options and determine whether shoulder stabilization surgery is the right next step.