Arthroscopic management of multidirectional instability.

Abstract

The most critical step in successful treatment of shoulder instability does not lie in surgical technique, but in accurate assessment of factors contributing to instability. Multidirectional instability (MDI) is initially treated with rehabilitation. The primary goal of rehabilitation is strengthening of the dynamic stabilizers, including the rotator cuff and scapular stabilizers. There are several surgical techniques described to manage MDI, ranging from the classic Neer inferior capsular shift to a variety of arthroscopic procedures. This article focuses on the arthroscopic management of MDI.