Complications in arthroscopic anterior shoulder stabilization: pearls and pitfalls

Arthroscopic treatment of anterior glenohumeral instability has become increasingly common. As longer-term follow-up studies become available, certain trends dictating the success or failure of arthroscopic stabilization are becoming more evident. Bone defects are important predictors of clinical failure, and the recognition of bone loss and other pathoanatomic variables can help determine which patients will benefit from arthroscopic stabilization for anterior glenohumeral instability. Arthroscopic techniques for anterior shoulder instability must mirror the focus of open methods on retensioning the inferior glenohumeral ligament and restoring the anatomy of the anterior capsulolabral complex. Arthroscopic stabilization for anterior glenohumeral instability has achieved results comparable to those of open stabilization methods in properly selected patients. Advantages of arthroscopic treatment of shoulder instability include lower morbidity, decreased pain, the ability to treat other pathologies, and improved cosmesis. As arthroscopic treatment of recurrent shoulder instability becomes more commonplace, it is crucial to review the factors that influence the success or failure of arthroscopic instability procedures and to understand the guidelines for patient selection, surgical pearls and pitfalls, and adjunctive technical details designed to optimize results.