Decision making in Anterior Shoulder Instability
Shoulder instability is a common problem with a significant impact on patients' daily functioning and sports life. Recurrent shoulder joint dislocations are most common in young people and active athletes. In certain cases, conservative treatment with intensive exercise therapy may be sufficient. When surgery is indicated, this can be done by anatomical restoration of the labrum and the capsulo-labral complex. However, studies have shown that certain factors such as young age, male gender, participation in contact sports, and bony humeral or glenoid lesions significantly increase the risk of recurrence after these procedures. An alternative is a bone block procedures, using the coracoid and conjoined sling or iliac crest graft. Recurrence rates are significantly lower but can be associated with a greater risk of complications. The correct assessment, surgical technique and postoperative rehabilitation are therefore of crucial importance. This lecture will elaborate on all these aspects of tackling the unstable shoulder.