POSTERIOR SHOULDER INSTABILITY IN ATHLETES

Posterior shoulder instability in athletes is usually the result of direct trauma during contact sports, repetitive microtrauma, and rarely, atraumatic causes. Computed tomography and magnetic resonance arthrography are the most sensitive imaging studies to identify posterior shoulder lesions. Certain athletes have characteristic physical examination and imaging findings, including positive jerk and Kim tests, that are indicative of posterior shoulder abnormality. Posterior arthroscopic capsulolabral reconstruction, although not as effective as anterior arthroscopic capsulolabral reconstruction, can still lead to a high rate of return to play. Open stabilization may be necessary for athletes with recurrent instability that has failed to respond to prior arthroscopic treatment or those who have substantial osseous injuries. Glenoid bone-block augmentation may be necessary for patients with recurrent dislocations associated with erosive glenoid changes or osseous deficiencies involving.25% of the glenoid.