Specialized Toolkit Series: Shoulder Instability-The Natural History of Nonoperative Treatment of Posterior Glenohumeral (GH) Instability

The Natural History of Nonoperative Treatment of Posterior Glenohumeral (GH) Instability

Video Transcription

Video Summary

Patrick Mescher presented research on non-operative treatment outcomes for isolated posterior shoulder instability, especially in young military athletes. In a retrospective study of 90 patients undergoing at least six months of physical therapy, 47% failed non-operative management, requiring surgery or leaving duty. Key risk factors for failure included increased posterior humeral head subluxation, posterior glenoid bone loss, higher posterior acromial height, reduced posterior acromial coverage, and glenoid retroversion over 10 degrees. Repeat MRIs showed worsening posterior glenoid bone loss in failed cases. The findings highlight anatomical factors influencing the success of conservative treatment for posterior shoulder instability.

Asset Caption

Patrick K. Mescher, M.D., M.B.A.

Keywords

posterior shoulder instability

non-operative treatment

military athletes

posterior glenoid bone loss

physical therapy failure risk factors