Joint Instability (Subscribe)  

The shoulder is the most commonly dislocated joint in the body. When shoulder dislocation occurs in adolescents and children, it has the worst natural history of any injury; the rate of recurrence in later years is at least 70%. As many as 95% of shoulder dislocations are anterior. Anterior dislocations...

Mechanism of anterior dislocations:
- combination of abduction, extension, and a posteriorly directed force applied to the arm;
- humeral head is driven anteriorly, tearing the shoulder capsule,...

Arthroscopic Stabilization for Bankart, Buford Lesion and Posterior-Inferior Laxity By: Mark Getelman Channel: Depuy Mitek Shoulder Surgeons: Gene Wolf, Mark Getelman

- is an avulsion of the anteroinferior glenoid labrum at its attachment to IGHL complex;
- lesion is felt to result from anterior shoulder dislocation and is felt to be primary lesion in recurrent anterior instability;
- when Bankart lesion occurs, there is obligitory...

The bony conformity of the glenoid and humeral head articular surfaces provides some of the stability of the shoulder. Frequently, patients with recurrent dislocations have bony deficits in one or both of these sur- faces. Glenohumeral instability with substantial glenoid defects or engaging Hill–Sachs lesions poses a difficult challenge for...

- posterolateral humeral head indentation fracture is created occuring from anterior shoulder dislocation, as soft base of humeral head impacts against relatively hard anterior glenoid;
- occurs in 35-40% of anterior dislocations & upto 80 % of recurrent dislocations
Wheeless' Textbook of Orthopaedics

Video presentation on a modification of the Laterjet procedure for shoulder instability using a mini plate.
Dr. Giovanni Di Giacomo

Multidirectional instability (MDI) is a relatively common, generally bilateral, atraumatic condition affecting shoulder function. MDI is caused by generalized capsular laxity—that is, insufficiency of the static ligament constraints. There is excessive mobility of the glenohumeral joint in all directions, although there may be a predominance of 1 direction, typically anteroinferior...

multidirectional instability implies three-way subluxations or dislocations either anteriorly, posteriorly, or inferiorly;
- these patients usually have no true Bankart lesion and incontrast patients have a capacious axillary pouch;
- affects overhead throwing atheletes, gymnasts, swimmers;
Wheeless' Textbook of Orthopaedics

Overview of Glenohumeral Instability, Michael L. Pearl, MD. Web Archive copy Last posted 2006
The shoulder faces unique challenges in comparison to other joints when it comes to stability. The arm moves through an extremely wide ROM, and often does so while under very heavy mechanical loads. To understand the mechanisms of...

- characterized by dislocation occuring after minor trauma, relative ease of relocation, and evidence of multidirectional instability;
- this condition is often present in overhead throwing athletes;
- it may lead to thoracic outlet syndrome (dead arm syndrome)
Wheeless Textbook of Orthopaedics

Webinar in Spanish produced Monday November 29th, 3:00pm PST.
Meeting Program
Should You Repair First Time Dislocators (Spanish) Juan-Carlos González
Advanced Arthroscopic Techniques for MDI (Spanish) Guillermo Arce
Open Repair for Instability (Spanish) A Daniel Moya
Management of Instability in Athletes (Spanish) Michael Simoni
Shoulder Instability (Spanish) Webinar Discussion Sergio L Checchia