Role of arthroscopy in treating anterior instability of the athlete's shoulder.

Introduction: Shoulder arthroscopy continues to use minimally invasive techniques to diagnose and treat the athlete's shoulder. Instability can result from trauma or repetitive forceful movements. Arthroscopy stabilization includes multiple quadrant surgery, proper capsular tensioning, and allows dynamic evaluation of the anatomic repair without disruption of the subscapularis.

Methods/materials: Bone deficits may limit soft tissue stabilization procedures. The arthroscope is helpful in determining the amount of glenoid bone loss, Hill-Sachs impression, positions of engagement, and associated soft tissue laxity that may compromise or alter treatment.

Results: A series of 450 patients are presented to review repairs-including 20 first-time dislocators, 24 revision surgeries, 330 suture anchor repairs, and 120 capsular repairs. Successful stabilization occurred in 93% of the patients studied.

Conclusion: Successful management of the unstable athlete's shoulder includes early intervention, near-normal range of motion, absent apprehension, and normal strength and function. Anatomic repairs provide the best opportunity for the athlete to return to their sport.