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Review
. 2024;12(12):820-825.
doi: 10.22038/ABJS.2024.81046.3697.

Clinical, Diagnostic, and Therapeutic Characteristics of Posterior Glenohumeral Instability

Akshay Khanna  1 , Mohamad Y Fares  1 , Jonathan Koa  1 , Peter Boufadel  1 , Ryan D Lopez  1 , Joseph A Abboud  1
Affiliations
Review

Clinical, Diagnostic, and Therapeutic Characteristics of Posterior Glenohumeral Instability

Akshay Khanna et al. Arch Bone Jt Surg. 2024.

Abstract

Posterior shoulder instability (PSI) is a shoulder pathology that is challenging to diagnose, leading to treatment delay and exacerbation of symptoms. Etiology can be both traumatic and atraumatic, and a comprehensive clinical history plays a significant role in achieving diagnosis. Imaging in the setting of PSI can reveal a reverse-Bankart lesion, a reverse Hill-Sachs lesion, posterior labral cysts, and potentially glenoid or lesser tuberosity fractures. Both conservative and surgical options exist for patients with PSI, and management often depends on case severity, extent of bone loss, and patient goals and expectations. Holistic patient education regarding the etiologies, mechanisms and possible treatment options available is pivotal for achieving high levels of patient satisfaction and optimal outcomes.

Keywords: Dislocation; Posterior instability; Reverse bankart; Reverse hill-sachs; Shoulder.

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Conflict of interest statement

JAA would like to disclose: Royalties from a company or supplier; Disclosures; OSTEOCENTRIC TECHNOLOGIES, ENOVIS, ZIMMER-BIOMET, STRYKER, GLOBUS MEDICAL, INC. Stocks in: SHOULDER JAM, AEVUMED, OBERD, OTS MEDICAL, ORTHOBULLETS, ATREON, RESTORE 3D. Research support from a company or supplier as a PI; Disclosures; ENOVIS, ARTHREX. Royalties, financial or material support from publishers; Disclosures; WOLTERS KLUWER, SLACK ORTHOPAEDICS, ELSEVIER. Board member/committee appointments for a society; Disclosures; AMERICAN SHOULDER AND ELBOW SOCIETY, MID ATLANTIC SHOULDER AND ELBOW SOCIETY, SHOULDER 360, PACIRA.

Figures

Figure 1
Figure 1
Physical exam maneuvers utilized to test for posterior shoulder instability
Figure 2
Figure 2
MRI images (axial view) showing a reverse Hill-Sachs lesion (yellow arrow) and a posterior capsulolabral lesion (white arrow) in a patient with posterior instability due to a prior dislocation event
Figure 3
Figure 3
Management options for posterior glenohumeral instability
See this image and copyright information in PMC

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