Arthroscopic treatment of anterior glenohumeral instability: indications and techniques

The arthroscopic treatment of anterior glenohumeral instability is becoming increasingly accepted as a viable treatment option because reported success rates parallel those of open stabilization techniques. This improved success rate is largely the result of advances in surgical techniques and technology. An improved understanding of the pathoanatomy associated with shoulder instability and continuing education initiatives have also been instrumental in expanding the indications for arthroscopic stabilization of the unstable shoulder. Important considerations during arthroscopy include identifying all pathology, mobilizing soft tissue, enhancing the local biology to promote soft-tissue healing to bone or to itself, securing anatomic fixation, and respecting the healing period during postoperative rehabilitation efforts. Principal contraindications include significant bone deficits and the inability to repair capsular avulsions or rupture. Adherence to these basic principles should lead to excellent results with arthroscopic stabilization of the unstable shoulder.