Up-to-date concepts and procedures in shoulder instability: a comprehensive review

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Engineering

Background:

• Anterior shoulder instability presents a significant clinical and socioeconomic challenge, particularly in young, active populations.
• Understanding critical and subcritical bone loss, bipolar lesions, and dynamic stabilization is crucial for effective management.
• Traditional soft-tissue procedures like the Bankart repair are effective for low-risk patients.

Purpose of the Study:

• To synthesize current evidence on managing anterior shoulder instability.
• To analyze recent clinical studies, biomechanical research, and technological advancements.
• To highlight the shift towards individualized treatment strategies based on patient-specific factors.

Main Methods:

• Systematic review of recent clinical studies and biomechanical research.
• Analysis of technological developments in shoulder instability management.
• Evaluation of emerging treatment algorithms and their evidence base.

Main Results:

• Emerging data support bony augmentation or dynamic stabilization for high-risk anterior shoulder instability cohorts.
• Technologies such as dynamic anterior stabilization, arthroscopic Latarjet, and suture-button fixation are redefining treatment.
• Individualized strategies considering bone loss, patient risk, and dynamic stabilization are reshaping the approach.

Conclusions:

• Recent advances necessitate an individualized, evidence-based approach to anterior shoulder instability.
• Dynamic stabilization and bony augmentation are increasingly important for high-risk patients.
• Optimizing clinical outcomes requires integrating new technologies and patient-specific factors into treatment algorithms.