title: Posterior Shoulder Instability.
abstract: BACKGROUND
  Posterior shoulder instability has become more frequently recognized and treated as a unique subset of shoulder instability, especially in the military. Posterior shoulder pathology may be more difficult to accurately diagnose than its anterior counterpart, and commonly, patients present with complaints of pain rather than instability. "Posterior instability" may encompass both dislocation and subluxation, and the most common presentation is recurrent posterior subluxation. Arthroscopic and open treatment techniques have improved as understanding of posterior shoulder instability has evolved.
  
  
  METHODS
  Electronic databases including PubMed and MEDLINE were queried for articles relating to posterior shoulder instability.
  
  
  METHODS
  Clinical review.
  
  
  METHODS
  Level 4.
  
  
  RESULTS
  In low-demand patients, nonoperative treatment of posterior shoulder instability should be considered a first line of treatment and is typically successful. Conservative treatment, however, is commonly unsuccessful in active patients, such as military members. Those patients with persistent shoulder pain, instability, or functional limitations after a trial of conservative treatment may be considered surgical candidates. Arthroscopic posterior shoulder stabilization has demonstrated excellent clinical outcomes, high patient satisfaction, and low complication rates. Advanced techniques may be required in select cases to address bone loss, glenoid dysplasia, or revision.
  
  
  CONCLUSIONS
  Posterior instability represents about 10% of shoulder instability and has become increasingly recognized and treated in military members. Nonoperative treatment is commonly unsuccessful in active patients, and surgical stabilization can be considered in patients who do not respond. Isolated posterior labral repairs constitute up to 24% of operatively treated labral repairs in a military population. Arthroscopic posterior stabilization is typically considered as first-line surgical treatment, while open techniques may be required in complex or revision settings.
authors.affiliation: Keller Army Hospital, West Point, New York.
authors.forename: Ivan J
authors.initials: IJ
authors.lastname: Antosh
authors.affiliation: Steadman-Hawkins Clinic of the Carolinas, Spartanburg, South Carolina.
authors.forename: John M
authors.initials: JM
authors.lastname: Tokish
authors.affiliation: Brown University Alpert Medical School, Providence, Rhode Island.
authors.forename: Brett D
authors.initials: BD
authors.lastname: Owens
mesh_terms: D001182:Arthroscopy; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008889:Military Personnel; D016059:Range of Motion, Articular; D012008:Recurrence; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012785:Shoulder Joint; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: instability; posterior stabilization; shoulder arthroscopy