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Multidirectional Instability of the Shoulder

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Shoulder Arthroscopy

Abstract

Shoulder instability is one of the most common pathologies treated by orthopedic sports medicine and shoulder surgeons. While the primary direction of instability is anteroinferior, there are patients who suffer from posterior instability as well as multidirectional instability (MDI). MDI indicates the patient has shoulder instability in two or more directions (anterior, inferior, posterior), and occurs when the static and dynamic restraints of the shoulder are not providing adequate stability. MDI is often seen in young adults and can present with shoulder instability, but more commonly presents as shoulder pain. The mainstay of treatment for MDI is nonoperative management with physical therapy aimed at scapular stabilization as well as rotator cuff and deltoid strengthening. Patients who have failed at least 6–12 months of conservative treatment can be considered for operative intervention such as arthroscopic capsular plication, rotator interval closure, or labral augmentation. However, every effort should be made to avoid surgical treatment of these patients when possible as the outcomes following surgery are variable.

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Acknowledgments

This chapter is an update of the one published in the previous edition and authored by Anthony A. Romeo and Benjamin Bruce.

Author information

Authors and Affiliations

  1. Rothman Orthopaedic Institute, New York, NY, USA

    Christopher L. Antonacci & Brandon J. Erickson

  2. Duly Health and Care, Elmhurst, IL, USA

    Anthony A. Romeo

  3. Duly Health and Care, Elmhurst, IL, USA

    Anthony A. Romeo

Authors
  1. Christopher L. Antonacci
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  2. Brandon J. Erickson
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  3. Anthony A. Romeo
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Editor information

Editors and Affiliations

  1. Department of Joint and Bone Surgery, University of Brescia, Brescia, Brescia, Italy

    Giuseppe Milano

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

    Andrea Grasso

  3. Shoulder and Upper Limb Department, St. Luke's Hospital, Bielsko-Biała, Poland

    Roman Brzóska

  4. Department of Traumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Ladislav Kovačič

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© 2023 The Author(s), under exclusive license to Springer-Verlag GmbH, DE, part of Springer Nature

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Antonacci, C.L., Erickson, B.J., Romeo, A.A. (2023). Multidirectional Instability of the Shoulder. In: Milano, G., Grasso, A., Brzóska, R., Kovačič, L. (eds) Shoulder Arthroscopy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-66868-9_18

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  • DOI: https://doi.org/10.1007/978-3-662-66868-9_18

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-66867-2

  • Online ISBN: 978-3-662-66868-9

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