Evolving Concepts in the Management of Shoulder Instability

Area of Science:

• Orthopaedic Surgery
• Sports Medicine
• Biomechanics

Background:

• Shoulder instability ranges from subluxation to dislocation, often requiring surgical intervention in active populations.
• Recurrent instability is a common challenge despite surgical treatment.
• Optimal management depends on instability severity and associated labral, capsular, or bony pathologies.

Purpose of the Study:

• Review current assessment and treatment of anterior shoulder instability.
• Highlight existing and future treatment modalities.
• Identify trends and deficiencies in current management strategies.

Main Methods:

• Comprehensive literature search of recent articles on shoulder instability.
• Focus on mechanism, diagnosis, and treatment of shoulder instability.
• Synthesis of information to provide a review and surgical algorithm.

Main Results:

• Multiple treatment options exist, including nonoperative management, open/arthroscopic Bankart repair, Latarjet, and remplissage.
• Orthopaedic surgeons are continuously refining management strategies.
• Long-term outcome data is crucial for determining the most appropriate treatment.

Conclusions:

• Management of shoulder instability requires consideration of diverse pathologies and patient factors.
• Ongoing research and outcome analysis are essential for advancing treatment efficacy.
• A clear algorithm for surgical treatment of anterior shoulder instability is presented.