Shoulder Anterior Instability

Anterior glenohumeral instability is a common injury among athletes, with a higher incidence compared to the general population, especially among contact athletes. Anterior dislocations account for about 95 % of instances, while posterior and inferior represent together less than 5 %. The most common lesion following an anterior traumatic dislocation is the Bankart lesion, in which the anteroinferior capsulolabral complex is torn away from the glenoid rim. This injury can also come with a bony fragment from the anteroinferior edge of the glenoid. The treatment of anterior shoulder instability is a heavily debated issue. A lot of factors enter in the decision-making process: age and level of activity of the patient, the kind of sport and the role of the athlete (overhead/thrower vs nonoverhead/nonthrower), the type of lesion (soft tissue or soft tissue and bony lesion), number of dislocations, and timing with respect to sport season. Immobilization, physical therapy, and bracing, with a delayed return to activity, are the basis of nonoperative management. Nearly 90 % of shoulder stabilization surgeries are arthroscopically performed, while a significant decline in the incidence of open Bankart repair has been observed in the United States.