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Management of Failed Shoulder Surgery pp 23–34Cite as

Management of Failed Posterior and Multidirectional Instability Repair

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Abstract

Posterior and multidirectional shoulder instability are relatively rare conditions but may be challenging to diagnose and treat. A vast number of factors may contribute to failure of initial treatment. Medical history, clinical examination, imaging, patient’s expectations, and compliance should be thoroughly revised when planning the treatment of a failed instability repair. General ligamentous laxity should be always assessed as a potential reason to treatment failure. Initial treatment is usually conservative and is associated with a relatively high recurrence rate especially in traumatic cases of posterior instability. Among surgical techniques, arthroscopic procedures have become superior to open methods. Each of operative techniques can be jeopardized with specific complications like painful hardware, lack of graft healing, limited range of motion, or neurological deficits. Osteoarthritis might be a result of an operative treatment as well as of neglecting of the surgery. Proper postoperative rehabilitation with passive motion should be applied in order to reduce risk of adhesive capsulitis. The most common techniques include posterior capsule-labral repair, modified McLaughlin procedure, open or arthroscopic bone block procedure, and scapula neck osteotomy and are described in this chapter.

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Author information

Authors and Affiliations

  1. Orthopaedic/Upper Limb, St. Luke’s Hospital, Bielsko-Biała, Poland

    Roman Brzóska

  2. Department of Orthopedics, St Luke’s Hospital, Bielsko-Biała, Poland

    Hubert Laprus & Patryk Kłaprocz

  3. Boni Fratres Catoviensis, Katowice, Poland

    Paweł Ranosz

  4. Ludwik Rydygier Memorial Specialized Hospital, Krakow, Poland

    Tomasz Rynkiewicz

Authors
  1. Roman Brzóska
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  2. Hubert Laprus
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  3. Paweł Ranosz
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  4. Patryk Kłaprocz
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  5. Tomasz Rynkiewicz
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Corresponding author

Correspondence to Roman Brzóska .

Editor information

Editors and Affiliations

  1. Department of Orthopaedics, Catholic University, Rome, Italy

    Giuseppe Milano

  2. Department of Orthopaedics, Casa di Cura Villa Valeria, Rome, Italy

    Andrea Grasso

  3. Clínica del Pilar , Zaragoza, Spain

    Angel Calvo

  4. Orthopaedic/Upper Limb, St. Luke’s Hospital, Bielsko-Biała, Poland

    Roman Brzóska

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Brzóska, R., Laprus, H., Ranosz, P., Kłaprocz, P., Rynkiewicz, T. (2018). Management of Failed Posterior and Multidirectional Instability Repair. In: Milano, G., Grasso, A., Calvo, A., Brzóska, R. (eds) Management of Failed Shoulder Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56504-9_4

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  • DOI: https://doi.org/10.1007/978-3-662-56504-9_4

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-56503-2

  • Online ISBN: 978-3-662-56504-9

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