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Recurrent Posterior Instability

Posterior instability is less common than anterior instability. It may be either traumatic or atraumatic in origin. Traumatic posterior dislocation typically follows a significant injury. More often posterior instability is associated with repetitive microtrauma.

Assessment is often multidisciplinary.

If the primary problem is one of abnormal muscle patterning and proprioreception then physiotherapy is main treatment.

If the primary problem structural then early surgery is recommended.

Surgical Options

(a) Soft Tissue Procedures:
Posterior CapsuloLabral repair
Capsular Shift
Capsular Shrinkage
Subscapularis Remplissage

(b) Bony Injuries:
Glenoid Osteotomy if > 20° retroversion
Subscapularis transfer - McLaughlin
- Neer’s modification
Posterior bone block

Rehabilitation Guide: Posterior Shoulder Stabilisation – Arthroscopic (LINK)