2021 Annual Meeting Shoulder Access Pass-Lessons Learned in Posterior Instability

Video Transcription

Video Summary

The speaker summarizes 29 years of experience with posterior shoulder instability, emphasizing it is common—often more than anterior—in athletes. Etiology differs between throwers (microtrauma, SLAP extension/type 8 tears, dynamic posterior instability) and contact athletes (direct trauma). Key exam findings and a “posterior three-pack” of tests help predict poor response to physical therapy and identify significant SLAP pathology. Imaging pitfalls include correctly measuring posterior glenoid bone loss (distinct pattern and axis); smaller glenoids and increasing bone loss raise failure risk (≈11% loss ~10% failure; 15% ~25%). Posterior pathology is often accompanied by SLAP, cuff, and capsular lesions. Arthroscopic repair with suture anchors/tape is reliable; contact athletes do best, throwers return at lower levels.

Asset Caption

Dr. James Bradley

Keywords

posterior shoulder instability

athlete shoulder injuries

posterior glenoid bone loss measurement

SLAP extension (type 8) tears

arthroscopic posterior labral repair