title: Identification and treatment of existing copathology in anterior shoulder instability repair.
abstract: Recurrent anterior instability is a common finding after traumatic glenohumeral dislocation in the young, athletic patient population. A variety of concomitant pathologies may be present in addition to the classic Bankart lesion, including glenoid bone loss; humeral head bone loss; rotator interval pathology; complex/large capsular injuries including humeral avulsions of the glenohumeral ligaments (HAGL lesions), SLAP tears, near circumferential labral tears, and anterior labral periosteal sleeve avulsions (ALPSA lesions); and rotator cuff tears. Normal anatomic variations masquerading as pathology also may be present. Recognition and treatment of these associated pathologies are necessary to improve function and symptoms of pain and to confer anterior shoulder stability. This review will focus on the history, physical examination findings, imaging findings, and recommended treatment options for common sources of copathology in anterior shoulder instability repair.
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.. Electronic address: brian.forsythe@rushortho.com.
authors.forename: Brian
authors.initials: B
authors.lastname: Forsythe
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Frank
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ahmed
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Nikhil N
authors.initials: NN
authors.lastname: Verma
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Cole
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Romeo
authors.affiliation: Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Provencher
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Shane J
authors.initials: SJ
authors.lastname: Nho
mesh_terms: D001182:Arthroscopy / Q000379:methods; D006801:Humans; D058430:Humeral Head; D006811:Humerus / Q000503:physiopathology; D007592:Joint Diseases / Q000473:pathology; D007593:Joint Instability / Q000150:complications* / Q000601:surgery; D008023:Ligaments, Articular / Q000293:injuries*; D012008:Recurrence; D012421:Rupture / Q000175:diagnosis; D012783:Shoulder Dislocation / Q000150:complications*; D012785:Shoulder Joint