Document Type
Article
Publication Date
8-15-2023
Abstract
The shoulder, being the most mobile joint in the human body, is often susceptible to dislocations and subluxations more so than other joints. As such, shoulder instability constitutes a common complaint among patients worldwide, especially those who are young, participate in contact sports, and have increased innate flexibility in their joints. Management options in the setting of instability vary between conservative and surgical options that aim to mitigate symptoms and allow return of function. Surgical options can be arthroscopic and open, with a general shift among surgeons towards utilizing arthroscopic surgery in the past several decades. Nevertheless, open procedures still play a role in managing shoulder instability patients, especially those with significant bone loss, recurrent instability, coexisting shoulder pathologies, and high risk of failure with arthroscopic surgery. In these clinical settings, open procedures, like the Latarjet procedure, open Bankart repair, glenoid bone augmentation using iliac crest autograft or distal tibial allograft, and salvage options like glenohumeral arthrodesis and arthroplasty may show good clinical outcomes and low recurrence rates. Each of these open procedures possesses its own set of advantages and disadvantages and entails a specific set of indications based on published literature. It is important to cater treatment options to the individual patient in order to optimize outcomes and reduce the risk of complications. Future research on open shoulder stabilization procedures should focus on the long-term outcomes of recently utilized procedures, investigate different graft options for procedures involving bone augmentation, and conduct additional comparative analyses in order to establish concrete surgical management guidelines.
Recommended Citation
Fares, Mohamad Y.; Boufadel, Peter; Daher, Mohammad; Koa, Jonathan; Khanna, Akshay; and Abboud, Joseph A., "Anterior Shoulder Instability and Open Procedures: History, Indications, and Clinical Outcomes" (2023). Rothman Institute Faculty Papers. Paper 227.
https://jdc.jefferson.edu/rothman_institute/227
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Language
English
Comments
This article is the author’s final published version in Clinics in Orthopedic Surgery, Volume 15, Issue 4, August 2023, Pages 521-533.
The published version is available at https://doi.org/10.4055/cios23018. Copyright © 2023 by The Korean Orthopaedic Association.