In a young active population, instability is the most common shoulder affliction. Patients can have a variety of pathologies concomitant with or in lieu of a traditional Bankart lesion. If all pathology is not recognized or treated appropriately, the patients’ shoulder instability, pain, and diminished function may persist. Treating patients with multiple foci of pathology thus represents a diagnostic and therapeutic dilemma. The objective of this report is to facilitate the recognition and treatment of several types of potentially confounding concomitant shoulder pathologies in otherwise active patients with instability.
Recurrent anterior instability is a common finding after traumatic glenohumeral dislocation in the active population. The basis for treatment of shoulder instability begins with a thorough preoperative history and physical examination, followed by careful evaluation, interpretation, and clinical correlation of imaging studies. Once the etiologic factors contributing to instability are identified, it is imperative to determine the presence or absence of copathologies. This is especially important preoperatively (to plan for specific repair strategies) and intraoperatively to prevent otherwise avoidable postoperative complications.
This review focuses on the history, physical examination findings, imaging findings, and recommended treatment options for common sources of copathology in anterior shoulder instability repair.