Digital ExclusiveGlenohumeral Instability Related to Special Conditions: SLAP Tears, Pan-labral Tears, and Multidirectional InstabilityVan Blarcum, Gregory S. MD; Svoboda, Steven J. MD Author Information Department of Orthopaedic Surgery at West Point; Keller Army Community Hospital, West Point, NY The views expressed in this presentation are those of the author and do not necessarily reflect the official policy or position of the Department of the Army, Department of the Navy, the Defense Health Agency, the Department of Defense, nor the US Government. Disclosure: The authors declare no conflict of interest. Reprints: Gregory S. Van Blarcum, MD, Department of Orthopedic Surgery, 900 Washington Road, West Point, NY 10996 Sports Medicine and Arthroscopy Review: September 2017 - Volume 25 - Issue 3 - p e12-e17 doi: 10.1097/JSA.0000000000000153 Buy Metrics Abstract Glenohumeral instability is one of the more common conditions seen by sports medicine physicians, especially in young, active athletes. The associated anatomy of the glenohumeral joint (the shallow nature of the glenoid and the increased motion it allows) make the shoulder more prone to instability events as compared with other joints. Although traumatic dislocations or instability events associated with acute labral tears (ie, Bankart lesions) are well described in the literature, there exists other special shoulder conditions that are also associated with shoulder instability: superior labrum anterior/posterior (SLAP) tears, pan-labral tears, and multidirectional instability. SLAP tears can be difficult to diagnose and arthroscopic diagnosis remains the gold standard. Surgical treatment as ranged from repair to biceps tenodesis with varying reports of success. Along the spectrum of SLAP tears, pan-labral tears consist of 360-degree injuries to the labrum. Patients can present complaining of either anterior or posterior instability alone, making the physical examination and advanced imaging a crucial component of the work up of the patients. Arthroscopic labral repair remains a good initial option for surgical treatment of these conditions. Multidirectional instability remains one of the more difficult conditions for the sports medicine physician to diagnose and treat. Symptoms may only be reported as vague pain versus frank instability making the diagnoses particularly challenging, especially in a patient with overall joint laxity. Conservative management to include physical therapy is the mainstay initial treatment in patients without an identifiable structural abnormality. Surgical management of this condition has evolved from open to arthroscopic capsular shifts with comparable results. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.