An Algorithmic Approach to the Management of Shoulder Instability.

J Am Acad Orthop Surg Glob Res Rev · Dec 2019 · Review

White AE, Patel NK, Hadley CJ, Dodson CC

Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA (Mr. White); VCU Health, PA (Mr. Hadley…

Shoulder & Elbow Sports Medicine

SUMMARY — THE REDUCTIONAlgorithm for shoulder instability: nonoperative care carries up to 87% recurrence in high-risk patients; CT/MR arthrography quantifies glenoid bone loss; arthroscopic stabilization suits minimal loss (~4% recurrence), while open procedures suit over 20% loss.
Abstract, as published

The recurrence of anterior shoulder instability can be as high as 86.7% in high-risk patients who are treated nonoperatively after their first incident of instability. CT and MR arthrography are necessary for preoperative imaging and assessment of glenoid bone loss. Patient expectations in conjunction with appropriate preoperative imaging are critical for surgical planning. Arthroscopic shoulder stabilization is often sufficient in most cases where glenoid bone loss is minimal, with recurrent dislocation rates close to 4% in the literature. Open stabilization procedures are generally indicated in patients with greater than 20% glenoid bone loss.

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