Recurrent anterior shoulder instability: Review of the literature and current concepts

Abstract

The purpose of this review article is to discuss the clinical spectrum of recurrent traumatic anterior shoulder instability with the current concepts and controversies at the scientific level. Because of increasing participation of people from any age group of the population in sports activities, health care professionals dealing with the care of trauma patients must have a thorough understanding of the anatomy, patho-physiology, risk factors, and management of anterior shoulder instability. The risk factors for recurrent shoulder dislocation are young age, participation in high demand contact sports activities, presence of Hill-Sachs or osseous Bankart lesion, previous history of ipsilateral traumatic dislocation, ipsilateral rotator cuff or deltoid muscle insufficiency, and underlying ligamentous laxity. Achieving the best result for any particular patient depends on the procedure that allows observation of the joint surfaces, provides the anatomical repair, maintains range of motion, and also can be applied with low rates of complications and recurrence. Although various surgical techniques have been described, a consensus does not exist and thus, orthopedic surgeons should follow and try to improve the current evidence-based treatment modalities for the patients.

Keywords: Recurrent instability, Glenohumeral joint, Dislocation, Shoulder, Review

Core tip: Recurrent anterior instability of the shoulder is a complex disorder which mainly affects younger population, and generally requires surgical intervention to restore joint stability. Although many authors published good to excellent clinical results regarding various techniques described in the literature, a consensus on the ideal treatment modality has not been established yet. In this review article, we present an overview of recurrent anterior instability of the glenohumeral joint and discuss the treatment options with current concepts.