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Management and Outcomes of In-Season Anterior Shoulder Instability in Athletes

Lemme, Nicholas J. MD1; Kuczmarski, Alexander S. MS1; Goodman, Avi D. MD1; Ready, Lauren V. MPH1; Dickens, Jonathan F. MD2; Owens, Brett D. MD1

doi: 10.2106/JBJS.RVW.19.00010
Review Articles

  • » Anterior shoulder dislocation is a common problem in athletes and has serious implications due to the rate of injury recurrence and the resulting extended time out of play.
  • » There are a variety of management options that address shoulder instability in an in-season athlete, and the decision-making approach should be individualized to the athlete.
  • » Although nonoperative management and return to play in the same season may be a suitable option for a subset of athletes who wish to return to play as soon as possible (during a recruiting season, for an upcoming Combine, or if they are in the last season of their career), given the high risk of recurrence, we recommend that immediate surgical intervention should be considered to decrease the risk of further damage to the glenohumeral joint.
  • » Arthroscopic stabilization currently is the most commonly performed intervention for athletes with anterior shoulder instability in the United States, but open repair remains an excellent option for high-risk patients.
  • » In collision athletes with subcritical glenoid bone loss between 13.5% and 25%, early open anterior capsulolabral reconstruction or a Latarjet procedure is recommended. If glenoid bone loss exceeds 25%, the Latarjet or another glenoid osseous augmentation procedure should be performed to reduce the risk of recurrent anterior instability.

1Department of Orthopaedic Surgery, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island

2Uniformed Services University of the Health Sciences, Bethesda, Maryland

Email address for N.J. Lemme:

Investigation performed at the Department of Orthopaedic Surgery, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island

Disclosure: The authors indicated that no external funding was received for any aspect of this work. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked “yes” to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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