Shoulder Dislocation: Risk of Recurrence

X-Ray of Shoulder Dislocation

Recurrent shoulder dislocation, also known as shoulder instability, occurs when the shoulder joint repeatedly slips out of its normal position. Several factors can contribute to an increased risk of recurrent shoulder dislocation. These risk factors include:

  1. Previous Shoulder Dislocation: Once an individual has experienced a shoulder dislocation, the risk of recurrence is higher compared to someone who has not had a previous dislocation. The risk increases further if the initial dislocation occurred at a younger age.
  2. Ligamentous Laxity: Some individuals naturally have looser or more lax ligaments, which can contribute to increased shoulder joint mobility and instability. Ligamentous laxity can be genetic or acquired through repetitive overhead activities or trauma.
  3. Trauma or Injury: High-impact injuries or trauma to the shoulder joint, such as a fall, sports-related injury, or motor vehicle accident, can damage the stabilizing structures of the shoulder, making it more prone to recurrent dislocations.
  4. Structural Abnormalities: Certain anatomical variations or structural abnormalities can predispose individuals to shoulder instability. The “Bankart” lesion or anterior labral tear is the structural damage that results from a dislocation. When the labrum/ligament remains displaced there is a loss of restraint that keeps the shoulder in place. Bone loss from an initial and more commonly repeated dislocations or subluxations increase the risk of recurrent dislocations and may need to be corrected at the time of surgery in addition to repairing torn ligaments. Other abnormalities, such as a loose joint capsule or abnormal bone shapes, can also contribute to instability.
  5. Muscle Weakness or Imbalance: Weakness or imbalances in the muscles surrounding the shoulder joint, particularly the rotator cuff and scapular stabilizers, can disrupt the dynamic stability of the shoulder and increase the risk of dislocation.
  6. Participation in Contact Sports or Overhead Activities: Engaging in sports or activities that involve repetitive overhead motions, forceful throwing, or contact can put stress on the shoulder joint and increase the risk of dislocation. Sports such as rugby, football, basketball, volleyball, and swimming are commonly associated with recurrent shoulder dislocation.
  7. Poor Rehabilitation or Noncompliance with Treatment: Inadequate rehabilitation following an initial shoulder dislocation or noncompliance with treatment protocols can lead to persistent muscle weakness, decreased joint stability, and an increased likelihood of subsequent dislocations.
Bone loss associated with recurrent shoulder dislocation. Glenoid (socket) bone loss leads to smaller surface area for humeral head (ball) to make contact with socket (glenoid).

It’s important to note that while these factors increase the risk of recurrent shoulder dislocation, not everyone with these risk factors will experience dislocations. Treatment options for recurrent shoulder dislocation may include physical therapy, strengthening exercises, bracing, and in some cases, surgical intervention to repair or stabilize the shoulder joint and reduce the risk of future dislocations. Consulting with a healthcare professional, such as an orthopedic specialist or sports medicine physician, can help assess individual risk factors and develop an appropriate treatment plan.

Surgical options I utilize include minimally invasive arthroscopic repairs and open repairs that address that pathology. Treatments are individualized based on the patients activity level, type of sports, age, hand dominance and lesions present.

Example of arthroscopic Bankart or ligament repair for recurrent shoulder instability

ACL REPAIR LECTURE: February 24, 2023 @ 8am

BEAR Implant for ACL Restoration and Recovery: A Cutting Edge Look into ACL Repair

I hope you will join me for a free lecture and continuing medical education credits on an exciting new procedure to repair (NOT RECONSTRUCT) the torn ACL. The technique, history of ACL treatments and my personal experience with this procedure will be covered.

Register: Click Here To Register

ACL Surgery: In The News

In a recent segment on NBC news I was interviewed about the ACL repair technique I have been performing utilizing the BEAR implant.

Dr Rizio interviewed on WNBC TV (link to interview)

This procedure repairs the injured ACL (Anterior Cruciate Ligament) and avoids the taking a graft from another pert of the knee or use of donor tissue. The procedure is best for acute tears (recent). I am available for consultation to determine which procedure is best for each patients injury.

Lecture: Prevention of Throwing Injuries

This is a short lecture on prevention of throwing injuries with the focus on baseball pitchers. The principles apply to athletes who participate in all overhead sports including tennis, javelin, football etc…

Closeup of baseball ball
Feel free to comment, like or share this presentation.

Press: Article from City Lifestyle Magazine

See my recently featured article on ACL repair and a new FDA approved implant. I have been performing this procedure and was the first in Northern New Jersey to perform the operation. I hope you enjoy the article.

ACL Repair with BEAR implant


The time has finally arrived! I will be moving my practice to the Ambulatory Care Center (ACC) in Livingston beginning April 4, 2022.

State of the art orthopaedic surgery office with valet and abundant onsite parking. X-ray on site.

Sports related conditions of the shoulder, knee and elbow

  • ACL Reconstruction & Repair
  • Rotator Cuff Repair
  • Shoulder Labral Repair
  • Tommy John Surgery
  • Meniscus Tears
  • Cartilage repair and regeneration
  • Shoulder and Knee Arthritis
  • Tennis Elbow
  • OCD (osteochondritis dissecans)
  • Many other shoulder, knee and elbow conditions as well

I look forward to seeing old and new patients for orthopaedic injuries, consults and second opinions in my new location!

Dr. Rizio performs First ACL Repair with BEAR Implant at Short Hills Surgery Center

ACL repair has long been considered an operation that will fail. In recent years there has been a renewed interest in repairing the ACL. Based upon new information, a revisiting of old research articles and newer devices has identified tears that may be amenable for repair. Success with repair in the proper patient can be achieved reliably and the native ACL can be saved.

The BEAR technique utilizes a recently FDA approved device to “bridge” the gap in the repair and enhance healing by promoting healing through the use of the patients own blood and growth factors, providing a scaffold for repair and blocking the synovial (joint) fluid from disrupting the repair process. This now allows for an even wider array of tear patterns to be amenable to repair.

Video representation of BEAR procedure (Hold link to open video)

This is particularly exciting for younger, pediatric patients that are still growing. This technique avoids the need to use the patient own tissue and allows for safe repair without as much risk to the growth plate. Dr. Rizio is accepting new patients interested in this technique and also many other sports related injuries. Dr. Rizio sees sports injuries in adult and pediatric patients.

To learn more about the actual device, clink the link below for the company website:

Ambulatory Care Center

200 South Livingston Avenue

Suite 230, West Wing

Livingston, NJ 07039

P: 973-322-7005

City Life Style Magazine – New article

Check out my latest article. Hope you enjoy and learn some more about my practice!

Orthopedic Sports Medicine Surgeon helping pediatric and adult athletes get back to competing for 20 years

Don’t Shoulder The Pain – Health & Life Magazine


Don’t Shoulder the pain – Health and Life Magazine

Read on –

Don’t Shoulder The Pain – Health & Life Magazine
— Read on

ACL (Anterior Cruciate Ligament) Repair

ACL tears are increasing in frequency secondary to increased levels of participation, frequency of games and practice.

ACL tears are a common injury and being seen with greater frequency and at younger ages. Tears lead to loss of time from sport and activities and can lead to further joint deterioration without prompt recognition and treatment. The standard treatment is a reconstruction with autograft (patients tissue) or allograft (donor, cadaveric tissue). The choice of graft depends on several factors including age of patient and sports activity level. Currently, the time to return to sport has been shown to effect re-injury rates. Historically, 6 months after surgical reconstruction was considered an appropriate time to return to sports without restrictions. This notion has been challenged by recent studies noting lower re-injury rates by waiting 9 months or more to return to sports.

ACL graft (hamstrings)

Newer surgical instruments and a retrospective look at studies from decades ago regarding primary repair have lead to resurgence in interest in primary repair instead of reconstruction. Failure rates have been high with this technique in previous studies that lead to the abandonment of this procedure. However, when evaluating the results or success of repair in specific tears, the results can approach that of a reconstruction. Specifically, proximal tears (from the femur) have better success when repaired. The advantage of a repair is that the ACL can be saved, less invasiveness and potentially faster return to sports. If the repair were to fail the standard options for reconstruction still exist. This is particularly attractive in pediatric patients where reconstruction techniques can injure growth plates.

Not every patient is a candidate but the option should be available for those patients inclined to have a repair over a reconstruction. I offer this to my patients who are appropriate candidates based on MRI appearance and surgical evaluation. Below is a short video demonstrating a repair I performed and the technique utilized.

Video of ACL Repair