Shoulder instability

Abstract

The importance of the labrum and glenohumeral ligament complex for the stability of the shoulder joint has been known since the beginning of this century. Shoulder instability may be classified into two large groups. TUBS, characterized by Traumatic, Unidirectional instability and Bankart lesion which often requires Surgery. The second group AMBRI, is characterized by Atraumatic, Multidirectional, Bilateral instability that often responds to Rehabilitation, but in case of surgery Inferior capsular shift is indicated. The high recurrence rate after primary traumatic anterior dislocation in young adults has caused an ongoing discussion about the indications for primary surgery. Anatomical reconstruction focusing on the pathoanatomy is recommended due to better results and a lower complication rate as compared to non-anatomical reconstruction that alters the normal anatomy and kinematics. The recurrence rate after arthroscopic Bankart repair is still generally higher than after open surgery but may be improved by better patient selection.