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

  • Giovanni MerollaEmail author
  • Simone Cerciello
  • Claudio Chillemi
  • Paolo Paladini
  • Elisa De Santis
  • Giuseppe Porcellini
General Review • SHOULDER - INSTABILITY

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.

Keywords

Shoulder Multidirectional instability Pathomechanics Arthroscopy Open surgery 

Notes

Acknowledgments

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

Conflict of interest

None of the authors have any conflicts of interest to disclose.

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Copyright information

© Springer-Verlag France 2015

Authors and Affiliations

  • Giovanni Merolla
    • 1
    • 2
    Email author
  • Simone Cerciello
    • 1
  • Claudio Chillemi
    • 3
  • Paolo Paladini
    • 1
  • Elisa De Santis
    • 2
    • 4
  • Giuseppe Porcellini
    • 1
  1. 1.Unit of Shoulder and Elbow Surgery“D. Cervesi” Hospital, CattolicaCattolicaItaly
  2. 2.“Marco Simoncelli” Biomechanics Laboratory“D. Cervesi” Hospital, CattolicaCattolicaItaly
  3. 3.Department of Orthopedics and TraumatologyIstituto Chirurgico Ortopedico Traumatologico (ICOT)LatinaItaly
  4. 4.Shoulder Team Rehabilitation OfficeForlìItaly

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