Abstract
The glenohumeral joint is the most dislocated articulation, accounting for more than 50% of all joint dislocations. The reason behind shoulder instability should be investigated in detail for successful management, and the treatment plan should be individualized for all patients. Several classification systems have been proposed for glenohumeral instability. A physical exam is mandatory no matter what classification system is used. When treating patients with anterior shoulder instability, surgeons need to be aware of the critical size of the bone loss, which is commonly seen. The glenoid track concept was clinically adopted, and the measurement of the glenoid track for surgical decision-making is recommended. Detailed assessment of existing soft tissue injury to the labrum, capsule, glenohumeral ligaments, and rotator cuff is also mandatory as their presence influences the surgical outcome. Rehabilitation, arthroscopic repair techniques, open Bankart procedure, capsular plication, remplissage, Latarjet technique, iliac crest, and other bone grafts offer the surgeon different treatment options according to the type of patient and the lesions to be treated. Three-dimensional (3D) technologies can help to evaluate glenoid and humeral defects. Patient-specific guides are low-cost surgical instruments and can be used in shoulder instability surgery. 3D printing will undoubtedly become an essential tool to achieve the best results in glenohumeral instability surgery.
Highlights
The shoulder is the most dislocated joint, which accounts for more than 50% of all joint dislocations [1]
The traumatic shoulder dislocations are generally classified according to the direction of the instability as anterior, posterior, inferior
The reason behind shoulder instability should be investigated in detail for successful management, and the treatment plan should be individualized for all patients
Summary
The shoulder is the most dislocated joint, which accounts for more than 50% of all joint dislocations [1]. When treating patients with anterior shoulder instability, surgeons need to be aware of the critical size of the bone loss (glenoid defect and Hill-Sachs lesion), which are commonly seen. The risk of recurrent instability is significantly higher following non-surgical treatment for these high-risk patients [32,33,34] For this reason, the choice of treatment for first episode dislocation has been shifted to primary shoulder stabilization for elite athletes and those with high risks [34]. Open Bankart surgery can (1) restore capsulolabral complex, (2) retensioning of pathologic capsule by plication, and (3) manage rotator interval lesion, it can resist high stress in collision sports athletes and heavy manual labor [44] This can be considered a valuable option between arthroscopic Bankart repair and bone block procedure [11]
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