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Recurrent Posterior Shoulder Instability

Dr. Millett is Co-Director, Harvard Shoulder Service/Sports Medicine, Brigham & Women’s Hospital, Massachusetts General Hospital, Boston, MA, and Assistant Professor, Department of Orthopaedic Surgery, Harvard Medical School. Dr. Clavert is Associate Professor, Department of Orthopaedics, CHRU Hautepierre, Strasbourg, France. Dr. Hatch is Assistant Professor, Sports Medicine/Shoulder & Elbow Services, Department of Orthopaedic Surgery, USC Keck School of Medicine, Los Angeles, CA. Dr. Warner is Professor, Department of Orthopaedics, Harvard Medical School, Boston, MA, and Chief, Harvard Shoulder Service, Department of Orthopedics, Massachusetts General Hospital.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Millett, Dr. Clavert, Dr. Hatch, and Dr. Warner.

Reprint requests: Dr. Millett, Steadman Hawkins Clinic, 181 West Meadow Drive, Vail, CO 81657.

Recurrent posterior shoulder instability is an uncommon condition. It is often unrecognized, leading to incorrect diagnoses, delays in diagnosis, and even missed diagnoses. Posterior instability encompasses a wide spectrum of pathology, ranging from unidirectional posterior subluxation to multidirectional instability to locked posterior dislocations. Nonsurgical treatment of posterior shoulder instability is successful in most cases; however, surgical intervention is indicated when conservative treatment fails. For optimal results, the surgeon must accurately define the pattern of instability and address all soft-tissue and bony injuries present at the time of surgery. Arthroscopic treatment of posterior shoulder instability has increased application, and a variety of techniques has been described to manage posterior glenohumeral instability related to posterior capsulolabral injury.