Decision-Making in Anterior Shoulder Instability

Abstract

The shoulder is the most frequently dislocated joint, accounting for more than half of all joint dislocations. Several classification systems have been proposed for glenohumeral instability. A physical exam is mandatory, despite which classification system is applied. When treating patients with anterior shoulder instability, surgeons must be aware of the subcritical and critical size of bone loss, which is commonly seen. The glenoid track concept may guide surgeons in decision-making by using the glenoid track measurement. A detailed assessment of the existing soft tissue injury to the labrum, capsule, glenohumeral ligaments, and rotator cuff is also mandatory, as their presence influences the surgical outcome. Non-operative measures such as rehabilitation, arthroscopic repair techniques, open Bankart procedure, remplissage, and bone-block procedures offer the surgeon different treatment options according to the characteristic of the patient and the lesions to be treated.