Purpose of review: Traumatic anterior instability is a common source of shoulder dysfunction in contact and collision athletes. There has been recent controversy surrounding the definitive treatment of this problem. The purpose of this review is to discuss recent advances in treatment of traumatic anterior shoulder instability.
Recent findings: Distinction has been made between contact and collision athletes and non-contact athletes because the former experience significantly more traumatic events per athletic exposure and are higher risk of sustaining an injury to the shoulder. The results of non-operative treatment of anterior instability tend to be poor. Overall, the rate of recurrence is estimated to be about 67%, with higher rates of recurrence in younger patients. Although some athletes may elect to return to play if the initial instability episode occurs during the season, definitive treatment involves surgical stabilization of the shoulder. Surgical treatment for this condition in contact and collision athletes sparks much debate, particularly with significant improvement in arthroscopic surgical techniques. Early reports showed high rates of failure with arthroscopic techniques. More recent evidence suggests that if performed under appropriate circumstances, both open and arthroscopic techniques have comparable results.
Summary: Participation in contact and collision sports places athletes at increased risk of recurrent traumatic anterior shoulder instability. Therefore, treating orthopaedists need to have an excellent understanding of anatomy, associated injuries, pathophysiology and current surgical techniques in order to effectively get players back on to the field.
Coordinator, Sports Medicine Services, Department of Orthopaedic Surgery, Washington Hospital Center, Washington, DC, USA
Correspondence to Wiemi A. Douoguih, Coordinator, Sports Medicine Services, Department of Orthopaedic Surgery, Washington Hospital Center, 106 Irving St. NW, Suite 215, Washington, DC 20010, USA
Tel: 202 291 9266; fax: 202 291 7689; e-mail: Wiemi38@earthlink.net