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Posterior shoulder instability: current concepts review

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Abstract
Purpose: Posterior shoulder instability has been difficult to diagnose and even more challenging to manage. However, it is being diagnosed and treated more frequently, particularly after sports injuries. The purpose of this article is to review literature concerning the management of these pathologies. Methods: A literature review was carried out in the main medical databases to evaluate the several studies concerning the open and arthroscopic treatment of posterior shoulder instability. Results: Because of better awareness of the pathology, better technical investigations, and a better understanding of shoulder biomechanics, more and more mechanical factors that can cause posterior instability have been described. Structural abnormalities can be divided into bony abnormalities and soft-tissue abnormalities. Each group can also be divided into abnormalities caused by trauma (macro- or microtrauma) or congenital. These abnormalities can be treated with non-anatomic and anatomic stability procedures. During the last decades, the latter have been described more frequently, most of them arthroscopically. Conclusion: For surgical treatment to be successful, the instability must be attributable to mechanical factors that can be modified by surgery. Because of better knowledge of the pathology, a more specific surgery can be performed. This lesion-specific surgery has improved clinical results compared to non-anatomic stability procedures, particularly when that surgery has been performed arthroscopically.
Keywords
ROTATOR CUFF TEAR, FRACTURE-DISLOCATIONS, MULTIDIRECTIONAL INSTABILITY, POSTEROINFERIOR INSTABILITY, GLENOHUMERAL INSTABILITY, ARTHROSCOPIC MANAGEMENT, MCLAUGHLIN PROCEDURE, GLENOID HYPOPLASIA, CAPSULAR PLICATION, HUMERAL HEAD, Posterior shoulder instability, Structural abnormalities, Open treatment, Arthroscopic treatment, Review

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Chicago
Van Tongel, Alexander, Anne Karelse, Bart Berghs, René Verdonk, and Lieven De Wilde. 2011. “Posterior Shoulder Instability: Current Concepts Review.” Knee Surgery Sports Traumatology Arthroscopy 19 (9): 1547–1553.
APA
Van Tongel, A., Karelse, A., Berghs, B., Verdonk, R., & De Wilde, L. (2011). Posterior shoulder instability: current concepts review. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 19(9), 1547–1553.
Vancouver
1.
Van Tongel A, Karelse A, Berghs B, Verdonk R, De Wilde L. Posterior shoulder instability: current concepts review. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 2011;19(9):1547–53.
MLA
Van Tongel, Alexander, Anne Karelse, Bart Berghs, et al. “Posterior Shoulder Instability: Current Concepts Review.” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 19.9 (2011): 1547–1553. Print.
@article{1900603,
  abstract     = {Purpose: Posterior shoulder instability has been difficult to diagnose and even more challenging to manage. However, it is being diagnosed and treated more frequently, particularly after sports injuries. The purpose of this article is to review literature concerning the management of these pathologies. 
Methods: A literature review was carried out in the main medical databases to evaluate the several studies concerning the open and arthroscopic treatment of posterior shoulder instability. 
Results: Because of better awareness of the pathology, better technical investigations, and a better understanding of shoulder biomechanics, more and more mechanical factors that can cause posterior instability have been described. Structural abnormalities can be divided into bony abnormalities and soft-tissue abnormalities. Each group can also be divided into abnormalities caused by trauma (macro- or microtrauma) or congenital. These abnormalities can be treated with non-anatomic and anatomic stability procedures. During the last decades, the latter have been described more frequently, most of them arthroscopically. 
Conclusion: For surgical treatment to be successful, the instability must be attributable to mechanical factors that can be modified by surgery. Because of better knowledge of the pathology, a more specific surgery can be performed. This lesion-specific surgery has improved clinical results compared to non-anatomic stability procedures, particularly when that surgery has been performed arthroscopically.},
  author       = {Van Tongel, Alexander and Karelse, Anne and Berghs, Bart and Verdonk, Ren{\'e} and De Wilde, Lieven},
  issn         = {0942-2056},
  journal      = {KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY},
  keyword      = {ROTATOR CUFF TEAR,FRACTURE-DISLOCATIONS,MULTIDIRECTIONAL INSTABILITY,POSTEROINFERIOR INSTABILITY,GLENOHUMERAL INSTABILITY,ARTHROSCOPIC MANAGEMENT,MCLAUGHLIN PROCEDURE,GLENOID HYPOPLASIA,CAPSULAR PLICATION,HUMERAL HEAD,Posterior shoulder instability,Structural abnormalities,Open treatment,Arthroscopic treatment,Review},
  language     = {eng},
  number       = {9},
  pages        = {1547--1553},
  title        = {Posterior shoulder instability: current concepts review},
  url          = {http://dx.doi.org/10.1007/s00167-010-1293-z},
  volume       = {19},
  year         = {2011},
}

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