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Posterior Shoulder Instability Classification, Assessment, and Management: An International Delphi Study
Summary
International shoulder experts reached consensus on classifying posterior shoulder instability (PSI) into traumatic, microtraumatic, and atraumatic subgroups. These classifications inform tailored assessment and management strategies for improved patient outcomes.
Area of Science:
- Orthopedics
- Sports Medicine
- Physical Therapy
Background:
- Posterior shoulder instability (PSI) presents unique diagnostic and therapeutic challenges.
- Consensus among international experts is crucial for standardizing PSI management.
Framework:
- Established three distinct subgroups for PSI: traumatic, microtraumatic, and atraumatic.
- Achieved high agreement (≥98%) on these classifications among participating experts.
Implementation:
- A 3-round e-Delphi survey was conducted with 47 international shoulder experts.
- Consensus required a minimum of 70% agreement per round on PSI classification, assessment, and management.
Implications:
- The agreed-upon framework differentiates clinical presentation and management for PSI subgroups.
- Recommendations emphasize considering sport/work participation and associated risks for personalized care.
