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Multidirectional instability of the shoulder: biomechanics, clinical presentation, and treatment strategies

  • General Review • SHOULDER - INSTABILITY
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Abstract

Multidirectional instability (MDI) of the shoulder is a condition where the dislocation occurs in more than one direction with minimal or no causative trauma. Its pathoanatomy is complex and characterized by a redundant capsule, resulting in increased glenohumeral joint volume. The fact that several further factors may contribute to symptom onset complicates the diagnosis and hampers the identification of a therapeutic approach suitable for all cases. There is general agreement that the initial treatment should be conservative and that surgery should be reserved for patients who have not responded to an ad hoc rehabilitation program. We review the biomechanics, clinical presentation, and treatment strategies of shoulder MDI.

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Acknowledgments

The authors are grateful to Word Designs (www.silviamodena.com) for the language revision.

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Authors and Affiliations

  1. Unit of Shoulder and Elbow Surgery, “D. Cervesi” Hospital, Cattolica, AUSL della Romagna Ambito Territoriale di Rimini, Cattolica, Italy

    Giovanni Merolla, Simone Cerciello, Paolo Paladini & Giuseppe Porcellini

  2. “Marco Simoncelli” Biomechanics Laboratory, “D. Cervesi” Hospital, Cattolica, AUSL della Romagna Ambito Territoriale di Rimini, Cattolica, Italy

    Giovanni Merolla & Elisa De Santis

  3. Department of Orthopedics and Traumatology, Istituto Chirurgico Ortopedico Traumatologico (ICOT), Latina, Italy

    Claudio Chillemi

  4. Shoulder Team Rehabilitation Office, Forlì, Italy

    Elisa De Santis

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  1. Giovanni Merolla
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Correspondence to Giovanni Merolla.

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Merolla, G., Cerciello, S., Chillemi, C. et al. Multidirectional instability of the shoulder: biomechanics, clinical presentation, and treatment strategies. Eur J Orthop Surg Traumatol 25, 975–985 (2015). https://doi.org/10.1007/s00590-015-1606-5

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