Technical Pearls for Shoulder Instability

Glenohumeral instability is one of the most common conditions of the upper extremity, especially in athletes and active individuals. Over the past two decades, there has been a transformation of surgical treatment from traditionally open repair/reconstruction to arthroscopic management. This has especially been true with management of both anterior and posterior instability without significant bone loss. In this setting, and in certain patient populations (eg, contact/collision athletes), arthroscopic treatment may not be sufficient. Therefore, open techniques, such as coracoid bone transfer, also occupy an important role in management of glenohumeral instability. The goal of this review is to provide technical "pearls" in management of glenohumeral instability. Specifically, the review will highlight treatments such as arthroscopic anterior and posterior instability repair, posterior glenoid bone augmentation, and open coracoid transfer (Latarjet) for anterior instability with bone loss. We will also review management of complications related to coracoid transfer.