Open Treatment of Anteroinferior Instability in the Throwing Athlete

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Summary:Anteroinferior shoulder instability is a common surgical problem in throwing athletes. The pathophysiology involves injury to the anterior capsulolabral complex, causing various degrees of instability ranging from subtle instability to frank dislocation. Multiple surgical procedures have been described for open reconstruction, the most common of which include anteroinferior capsular shift (AICS), anterior capsulolabral reconstruction (ACLR), and T-plasty modification of the Bankart procedure. Overall satisfactory results have been achieved in the majority of patients, with a recurrence rate of 1.5% to 10%. Return to sport has been difficult to achieve and may depend on the degree of instability observed. ACLR is successful in subluxators with subtle instability, whereas AICS is a reliable procedure in patients with varying grades of instability, including a history of multiple dislocations.

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