York, ME (207) 363 3490 | Portsmouth, NH (603) 431 1121

20Hip Care
10Hip-Conditions and Injuries
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Deep Gluteal Space Syndrome
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
10Hip-Treatment and Surgeries
Gluteal Repair
Labral Debridement
Labral Reconstruction
Labral Repair
Psoas Release
Trochanteric Bursa Debridement
33Knee Care
13Knee Conditions and Injuries
ACL Tear
Cartilage Injury
Discoid Meniscus
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteochondritis Dessicans
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
20Knee Treatment and Surgeries
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Medial Patellofemoral Ligament (MPFL) Reconstruction
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Knee Replacement (MAKO)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Total Knee Replacement (MAKO)
20Shoulder Care
10Shoulder-Conditions and Injuries
AC Joint Injuries
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
10Shoulder-Treatment and Surgeries
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement


During a shoulder dislocation, the proximal humerus (ball) usually pops out the front of the glenoid (socket). Shoulder dislocations usually occur following a direct impact with the shoulder in a certain position. When the shoulder dislocates, the labrum (bumper) in the front of the shoulder tears and the tissue that surrounds the shoulder joint (capsule) stretches. In addition, in some patients, a piece of the proximal humerus or socket (glenoid) may chip off (fracture) when the ball falls out of the socket. This chip fracture on the humerus is called a “Hill-Sachs lesion.”


  • Sharp, intermittent shoulder pain
  • Fear or “apprehension” that another dislocation will occur
  • Limited ability to play sports

Diagnosis And Treatment

Dr. Welch considers each patient’s symptoms, as well as a detailed physical examination and x-rays to make the diagnosis of shoulder instability. Dr. Welch usually orders an MRI or CT scan to confirm the diagnosis and evaluate the injury further. Most patients with only one dislocation can be treated successfully without surgery with a dedicated physical therapy program that helps strengthen the muscles and ligaments around the shoulder.

In those patients who are young (less than 20 years old), who are competitive athletes, or who sustain more than two or three dislocations, Dr. Welch will likely recommend surgery. Surgery usually involves a minimally invasive procedure in which Dr. Welch uses an arthroscope and surgical instruments to repair the torn labrum in the front of the shoulder. In those patients with a “Hill-Sachs” lesion, Dr. Welch may also perform a Remplissage technique to further stabilize the shoulder. In those patients who have failed previous arthroscopic surgery or in those patients who have glenoid (socket) bone loss, Dr. Welch may recommend a larger procedure called a Latarjet procedure.

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