Management of Failed Posterior and Multidirectional Instability Repair

  • Roman BrzóskaEmail author
  • Hubert Laprus
  • Paweł Ranosz
  • Patryk Kłaprocz
  • Tomasz Rynkiewicz


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.


Shoulder instability Posterior instability Multidirectional instability Failure Revision 


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Copyright information

© ESSKA 2018

Authors and Affiliations

  • Roman Brzóska
    • 1
    Email author
  • Hubert Laprus
    • 2
  • Paweł Ranosz
    • 3
  • Patryk Kłaprocz
    • 2
  • Tomasz Rynkiewicz
    • 4
  1. 1.Orthopaedic/Upper LimbSt. Luke’s HospitalBielsko-BiałaPoland
  2. 2.Department of OrthopedicsSt Luke’s HospitalBielsko-BiałaPoland
  3. 3.Boni Fratres CatoviensisKatowicePoland
  4. 4.Ludwik Rydygier Memorial Specialized HospitalKrakowPoland

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