Management of Multidirectional Instability of the Shoulder

Multidirectional Instability of the Shoulder: A Systematic Review

“…MDI without hyperlaxity may reveal anterior and posterior capsulolabral lesions. 9 No definitive data are available in the literature on the prevalence of capsulolabral or bony defects in patients with MDI. Several of the included studies did not include patients with Bankart or bony lesions.…”

“…Motivated patients with appropriate protocols typically respond well and may not need further management. 9 However, variable results have been reported.…”

Effects of Varying Locations for Biceps Tendon Tenotomy and Superior Labral Integrity on Shoulder Stability in a Cadaveric Concavity-Compression Model

“…[8][9][10] Because of its unique role as an attachment for the LHB, the superior labrum is thought to enhance glenohumeral stability by anchoring the LHB as well as increasing the shoulder's resistance to torsional forces. 11,12 We hypothesized that shoulder stability would still be affected with detachment of the superior labrum after a proximal biceps tenotomy when the anchoring function of the labrum is no longer relevant.…”

Generalized joint laxity and multidirectional instability of the shoulder

“…Repetitive microtrauma is the most common etiology in patients involved in repetitive overhead activities, particularly in sports such as volleyball, swimming and gymnastics. An accumulation of shear forces caused by persistent shoulder subluxation or microtrauma leads to a loss of chondrolabral containment with subsequent development of labral injuries (12,13). The prevalence of generalized joint laxity in patients with MDI and shoulder laxity ranges between 40 and 70% (12,25,34,35).…”

“…There is a wide spectrum of asymptomatic laxity in the anterior, posterior and inferior planes (11). Shoulder instability, on the other hand, is a pathological condition, characterized by the presence of symptoms in conjunction with abnormal laxity, which is indicative of deficient static and dynamic glenohumeral stabilizers (12,13). Several studies suggest that individuals with generalized joint laxity are at risk of musculoskeletal injuries (14)(15)(16)(17).…”