Management of Posterior Shoulder Instability in the Contact Athlete

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Posterior shoulder instability represents a unique pathologic subset affecting the glenohumeral-capsulolabral complex. Precise diagnosis and operative management have traditionally been challenging and often resulted in mixed clinical outcomes. However, recent advances in our understanding of pathogenesis and mechanisms of injury, as well as technological developments, have led to successful functional outcomes, high rate of return to sport, and return to previous level of play for the contact athlete. This article discusses important operative indications to consider, physical examination findings leading to poor response to treatment, and the value of precise assessment and recognition of concomitant injuries. Preferred arthroscopic and open stabilization techniques will also be described with subsequent discussion of superiority of techniques specific for the contact athlete subgroup.