Posterior Shoulder Stabilisation தகவல் In-depth ஒப்புதல்

Why this operation has been suggested

Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, starts with the least invasive options that suit your condition. Patients are generally referred to our clinic by their GP; if a physiotherapist has suggested you see us, you will still need a referral from your GP in order to be eligible for the Medicare rebate. A clinic assessment establishes the diagnosis. We usually try non-operative care first and consider surgery when that has not given enough improvement.

Arthroscopic posterior shoulder stabilisation is a keyhole procedure to repair the structures that keep your shoulder joint in place. It is typically offered when recurrent instability persists despite conservative treatment. Our goal is to restore stability and reduce pain. Arthroscopic stabilization results in good outcomes with high patient satisfaction and low rates of recurrent instability.

Before the operation

Please fast for seven hours before your surgery. We ask for this specific window so your procedure can be brought forward if the theatre list runs early. You do not need to restrict clear fluids during this time, but no food is allowed. Please arrange for someone to drive you home and stay with you for the first night. Wear comfortable, loose clothing to your appointment. Bring a list of all current medications. Your surgeon will advise which medicines to stop, so please follow their specific instructions. Most patients do not need blood tests or an anaesthetic review. If you have other medical conditions, you may need these checks. Bring any recent imaging, such as X-rays or MRI scans, to help us plan your operation.

On the day

You present to the hospital’s surgical admissions unit. Here you are checked in and prepared for theatre. You meet the anaesthetist to discuss your care. This operation is done under general anaesthetic. A regional nerve block is sometimes added for post-operative pain relief — the anaesthetist will discuss this with you on the day.

You are then taken into the operating theatre, where the operation is performed. You wake up in the recovery area, where nurses monitor you while the anaesthetic wears off. Once you are stable you either go to the ward or go home, depending on the procedure and your recovery.

What the operation involves

Your surgeon will likely perform arthroscopic stabilization. This uses small keyhole cuts rather than one large incision. A camera and special tools are inserted through these tiny openings. This approach allows your surgeon to repair the structures inside your shoulder joint. It is effective for managing both recurrent subluxations and frank instability.

If the instability is caused by bone loss, your surgeon may use a bone block. This involves taking a small piece of bone from another part of your body, such as the hip. This bone is then attached to the shoulder socket. This method helps to prevent the shoulder from slipping backward again. In some cases, your surgeon may also correct the shape of the shoulder blade (scapula). Fixing this anatomy helps to restore stability and reduce static subluxation.

The procedure typically takes between 4.3 and 8.6 months to allow a return to sport, though the actual surgery time is shorter. After the repair is complete, your surgeon will close the small cuts with sutures or glue. A dressing is applied to protect the area while you begin your recovery.

After the operation

You will wake up in our recovery ward. We manage your pain using standard methods. Your shoulder will be supported in a sling, and a dressing covers the small cuts. You must have someone stay with you for the first 24 hours. Your team will tell you whether you go home the same day or stay one night in hospital. We keep your arm still to protect the repair. Do not drive while in a sling or taking strong pain medication. See our guide on driving after upper-limb surgery for full details. Rest and follow our wound care advice closely.

Recovery

In the first few days, you can expect some swelling and discomfort. This is normal. Your surgeon will guide you on managing this pain safely. Keeping your arm supported and resting helps the swelling settle.

You will wear a sling to protect your shoulder while it heals. We do not use hinged braces or abduction pillows for this procedure. Your physiotherapist will guide you through gentle movements as soon as it is safe to begin. These exercises are key to restoring strength and stability.

At home, you will need help with tasks like cooking or dressing initially. Simple activities are fine, but avoid heavy lifting or reaching behind your back. Sleep may be tricky at first; propping yourself up with pillows often helps.

As your movement returns, you will gradually resume daily routines. You can return to driving once your surgeon clears you and you are off strong pain medication. For universal rules on driving after upper-limb surgery, please see our dedicated guide.

Your timeline may differ from others. Your surgeon and physiotherapist will guide you based on how your shoulder responds. Recovery is a process, and patience is important.

What can go wrong

Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.

If you have a posterior bone block procedure, you might notice that your shoulder feels stiff or painful in ways that do not improve over time. The surgery aims to stop the joint from slipping backward, but sometimes the results are not as strong as hoped. You may find that your shoulder still feels unstable or weak during daily tasks. If you feel that your recovery is not progressing or that the pain is not easing, please let us know. We can review your progress and discuss what might be happening.

Recurrence is another possibility. This means the shoulder slips out of place again. You might feel a sudden shift or a catching sensation in the joint. It could feel like the shoulder is about to dislocate again. If you experience this, contact our clinic promptly. We need to assess the joint to decide on the next steps.

In some cases, a glenoid osteotomy is performed. This involves reshaping the bone socket of the shoulder. With this approach, there is a higher chance that the instability may persist. You might continue to feel the same symptoms you had before surgery, such as pain or a feeling of looseness in the back of the shoulder. If your symptoms do not improve or get worse, bring this up at your next appointment. We can evaluate whether further treatment is needed.

The complications table on this page lists typical rates if you want the specifics.

When to call us

Call us if you have a fever, increasing wound redness or discharge, or sudden severe pain. Go to emergency if you notice calf swelling, shortness of breath, loss of sensation, or cannot move your limb. These signs need urgent assessment. We are here to help you stay safe during your recovery.

Advanced reading: the deeper science (optional)

This section goes further than you need for your own treatment decisions. Posterior shoulder instability is worth the extra reading because it behaves differently from the anterior version most people have heard of — and the difference runs in the direction you would not guess.

Posterior is the more stable repair, and the harder return

A meta-analysis comparing anterior with posterior instability after arthroscopic repair found that patients with anterior instability had higher return-to-sport rates but were more likely to have postoperative instability. Posterior patients were the reverse: the repair held better, but fewer got back to their sport [1].

That is worth sitting with, because it separates two things patients tend to fuse together. "Will my shoulder stay in?" and "will I get back to what I did?" have different answers here, and the second is the harder one.

The underlying results for the operation itself are good. A systematic review of 2,307 arthroscopic posterior stabilisations reported good outcomes with high patient satisfaction and low rates of recurrent instability, revision and residual pain [2]. A separate review of 1,047 athletes found high rates of return to sport, and relatively high rates of return to the pre-injury level [3]. Both findings can be true at once — posterior stabilisation is a reliable operation, and it is still a harder road back than its anterior counterpart.

What predicts failure

The most useful recent work is about who does badly. A systematic review of 960 patients identified three risk factors for failure or revision after arthroscopic posterior capsulolabral repair: female sex, reduced glenoid bone width, and preoperative glenoid bone loss greater than 11% to 15% [4].

Equally informative is what did not predict failure: glenoid version, type of sport, labral width and labral version showed no significant effect [4]. Version in particular is often discussed as though it were decisive, and on this evidence it is not.

The practical consequence is that the glenoid bone stock deserves proper assessment before surgery. Beyond roughly the 11–15% mark, a soft-tissue repair alone is working against mechanics it cannot fix, and that is the conversation to have before the operation rather than after a failure.

Why it gets missed

Posterior instability rarely presents as a dislocation. It is more often pain with a loaded, flexed arm — a bench press, a push-up, a hand pushing off a chair — with no history of the shoulder visibly coming out. That presentation invites the label of impingement or tendinopathy, and the diagnosis is frequently made late.

If you have pain pushing through a flexed arm and it has not responded to treatment aimed at the rotator cuff, posterior instability is worth specifically excluding.

References for the advanced reading

Vopat ML, Coda RG, Giusti NE, Baker J, Tarakemeh A, Schroeppel JP, et al. Differences in outcomes between anterior and posterior shoulder instability after arthroscopic Bankart repair: a systematic review and meta-analysis. Orthop J Sports Med. 2021;9(5).
Ralph JE, Hurley ET, Lunn K, Levin JM, Klifto CS, Owens BD, et al. Outcomes of arthroscopic stabilization for posterior shoulder instability: a systematic review. J Shoulder Elbow Surg. 2024;33(11):2530-8.
Matar RN, Shah NS, Gardner TJ, Grawe BM. Return to sport after surgical treatment for posterior shoulder instability: a systematic review. JSES Int. 2020;4(4):797-802.
Afetse EK, Noonan J, Munro A, Waterman BR, Ruzbarsky JJ, Kanakamedala AC, et al. Female sex, reduced glenoid bone width, and glenoid bone loss greater than 11% to 15% may increase the risk of failure after arthroscopic posterior capsulolabral repair: a systematic review. Arthroscopy. 2025;41(12):5332-42.e1.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

Arthroscopic stabilization of posterior shoulder instability yields promising early and midterm results [4].
Arthroscopic stabilization for posterior shoulder instability results in good outcomes, high patient satisfaction, low rates of recurrent instability, low rates of revisions, and low rates of residual pain [14].
Arthroscopic management of posterior-inferior shoulder instability has a successful track record and a minimal complication profile [8].
Arthroscopic surgical techniques have facilitated successful management of both recurrent posterior subluxations and frank posterior instability [9].
Successful correction of scapular anatomy (glenoid and acromion) at a minimum of 2 years can improve static subluxation and restore subjective and objective shoulder stability [2].
Posterior bone block augmentation for recurrent posterior shoulder instability does not reliably yield substantial improvements in patient-reported outcomes and is associated with frequently observed complications [12].
There is a high rate of return to sport after arthroscopic posterior shoulder stabilization, ranging from 4.3 to 8.6 months after surgery [15].
The thresholds defined in recent studies can provide a guideline for interpreting patient outcomes following arthroscopic stabilization for posterior shoulder instability, allowing for earlier detection of recurrent posterior instability [3].
Coracoid morphology differs significantly in patients undergoing posterior shoulder stabilization when compared to patients undergoing surgery for anterior instability or a comparison cohort [7].
Over the past several centuries, a number of procedures have been developed to address posterior shoulder instability as this pathology has become better understood [6].
Additional long-term randomized trials are needed to compare surgical positioning (beach-chair versus lateral decubitus) for posterior shoulder stabilization to better understand potential advantages and disadvantages [1].

Anatomy & Pathophysiology

Posterior shoulder instability pathology has become better understood over the past several centuries, leading to the development of various surgical procedures [6].
Advances in understanding posterior glenohumeral anatomy and biomechanics have improved comprehension of this disorder and guided clinical decision-making regarding surgical indications, contraindications, nonsurgical treatments, and stabilization techniques [16].
Posterior shoulder instability (PSI) is classified using the ABC classification, which distinguishes three groups based on the nature of pathology and two subtypes based on pathomechanical causes [17].
Female patients are significantly more likely to have posterior shoulder instability compared to anterior shoulder instability, whereas male patients are significantly more likely to have anterior shoulder instability [11].
Delayed diagnosis of posterior glenohumeral dislocations is common [18].
Coracoid morphology differs significantly in patients undergoing posterior shoulder stabilization compared to patients undergoing surgery for anterior instability or a comparison cohort [7].
Patients with constitutional static posterior shoulder instability (Type C1) differ from healthy controls regarding osseous scapular and humeral morphology, scapulothoracic orientation, and shoulder girdle muscle distribution [31].
Glenoid as well as acromial malalignment alone is associated with pathological posterior translation of the humeral head across the glenoid upon simulated active elevation [24].
The acromion acts as a mechanical buttress to posterior humeral head displacement [27].
Successful correction of scapular anatomy (glenoid and acromion) can improve static subluxation and restore subjective and objective shoulder stability at a minimum of 2 years [2].
Glenohumeral contact patterns highly depend on the amount of glenoid retroversion and posterior labral and/or bony glenoid integrity [25].
Posterior and posterior superior labral (PPS) injuries produce alterations in glenohumeral kinematics with implications for joint instability, increased joint loading, and potential joint damage [26].
The long head of the biceps has a pertinent biomechanical role in glenohumeral stability regardless of the condition of the superior labrum [28].
Surgical treatment of posterior shoulder instability must balance the necessity to repair torn capsulolabral tissues with the tendency to over constrain the shoulder [34].

Classification

Posterior shoulder instability is an uncommon condition that is often unrecognized, leading to incorrect diagnoses and delays [5].
The ABC classification distinguishes three groups of posterior shoulder instability based on the nature of pathology and two subtypes based on pathomechanical causes [17].
The ABC classification provides diagnostic criteria and treatment strategies for posterior shoulder instability [17].
Female patients are significantly more likely to have posterior shoulder instability compared to male patients, who are significantly more likely to have anterior shoulder instability [11].

Clinical Presentation

Recurrent posterior shoulder instability is an uncommon condition that is often unrecognized, leading to incorrect diagnoses and delays [5].
Bilateral posterior shoulder dislocations with reverse Hill-Sachs lesions are uncommon and prone to misdiagnosis [30].
In patients with suspected posterior glenohumeral instability, imaging can show abnormalities of the bone, labrum, and joint capsule [20].
Posterior shoulder instability is distinguished into three groups based on the nature of pathology and two subtypes based on pathomechanical causes in the ABC classification [17].
Female patients are significantly more likely to have posterior shoulder instability compared to anterior shoulder instability [11].
Successful correction of scapular anatomy can improve static subluxation and restore subjective and objective shoulder stability at a minimum of 2 years follow-up [2].
Arthroscopic management of posterior-inferior shoulder instability has a successful track record and minimal complication profile [8].
Arthroscopic stabilization of posterior shoulder instability resulted in good outcomes with high patient satisfaction and low rates of recurrent instability, revisions, and residual pain [14].
The early and midterm results of arthroscopic stabilization of the shoulder for posterior instability are promising [4].
Participants with microtraumatic posterior shoulder instability demonstrated significant improvements in patient-reported outcome measures and high rates of return to sport following a 24-week conservative rehabilitation program [21].
The thresholds defined in the study can provide a guideline for interpreting patient outcomes following arthroscopic stabilization for posterior shoulder instability, allowing for earlier detection of recurrent posterior instability [3].

Investigations

Delayed diagnosis of posterior glenohumeral dislocation is common [18].
Regardless of the radiologist interpretation of magnetic resonance arthrogram (MRA), patients with symptomatic posterior shoulder instability benefit from arthroscopic stabilization surgery [19].
In cases of traumatic posterior shoulder dislocation with associated acromion fracture, anatomical reduction and retention of the acromion fracture may be needed to prevent recurrent posterior instability [37].
Anterior greater tuberosity malunion after posterior shoulder fracture dislocation is a rare and debilitating condition [38].

Treatment

Non-Operative Management

NHL team physicians strongly favor nonoperative management in-season for initial posterior instability events of the shoulder [32].

Arthroscopic Stabilization

Regardless of the radiologist interpretation of MRA, patients with symptomatic posterior shoulder instability do benefit from arthroscopic stabilization surgery [19].
Additional long-term randomized trials comparing beach-chair and lateral decubitus positions are needed to better understand the potential advantages and disadvantages of surgical positioning for posterior shoulder stabilization [1].

Bone Block Augmentation

Posterior bone block augmentation for recurrent posterior shoulder instability does not reliably yield substantial improvements in patient-reported outcomes, and complications are frequently observed [12].
There is a moderate rate of recurrence following posterior bone block for posterior shoulder instability [13].
The iliac posterior shoulder bone-block is effective in managing instances of involuntary posterior shoulder instability, showing satisfactory results in terms of non-recurrence, pain relief, and function recovery [10].
Both glenoid osteotomy and bone block procedures can successfully address symptomatic posterior shoulder instability [22].

Scapular Osteotomy

At a minimum of 2 years successful correction of scapular anatomy can improve static subluxation and restore subjective and objective shoulder stability [2].

Outcome Interpretation

The thresholds defined in this study can provide a guideline for interpreting patient outcomes following arthroscopic stabilization for posterior shoulder instability, allowing for earlier detection of recurrent posterior instability [3].

Complications

Posterior bone block augmentation for recurrent posterior shoulder instability does not reliably yield substantial improvements in patient-reported outcomes [12].
Complications are frequently observed following posterior bone block augmentation for recurrent posterior shoulder instability [12].
There is a moderate rate of recurrence following posterior bone block procedures for posterior shoulder instability [13].
Glenoid osteotomy for posterior shoulder instability is associated with a high rate of persistent instability [40].

Recovery

Arthroscopic stabilization of posterior shoulder instability results in good outcomes with high patient satisfaction [14].
Arthroscopic stabilization of posterior shoulder instability is associated with low rates of recurrent instability [14].
Arthroscopic stabilization of posterior shoulder instability is associated with low rates of revisions [14].
Arthroscopic stabilization of posterior shoulder instability is associated with low rates of residual pain [14].
There is a high rate of return to sport after arthroscopic posterior shoulder stabilization [15].
Return to sport after arthroscopic posterior shoulder stabilization ranges from 4.3 to 8.6 months after surgery [15].
There are high rates of return to sport among athletes who underwent surgical treatment for posterior shoulder instability [23].
There are relatively high rates of return to preinjury level of sport among athletes who underwent surgical treatment for posterior shoulder instability [23].
Arthroscopic posterior Bankart repair for traumatic posterior shoulder instability in collision sports athletes results in a low recurrence rate [35].
Arthroscopic posterior Bankart repair for traumatic posterior shoulder instability in collision sports athletes results in a high return-to-play rate [35].
Arthroscopic posterior Bankast repair for traumatic posterior shoulder instability in collision sports athletes results in clinically meaningful improvement [35].
Participants with microtraumatic posterior shoulder instability demonstrated significant improvements in patient-reported outcome measures following a 24-week conservative rehabilitation program [21].
Participants with microtraumatic posterior shoulder instability demonstrated high rates of return to sport following a 24-week conservative rehabilitation program [21].
Successful correction of scapular anatomy can improve static subluxation [2].
Successful correction of scapular anatomy can restore subjective shoulder stability [2].
Successful correction of scapular anatomy can restore objective shoulder stability [2].
The iliac posterior shoulder bone-block is effective in managing instances of involuntary posterior shoulder instability [10].
The iliac posterior shoulder bone-block shows satisfactory results in terms of non-recurrence [10].
The iliac posterior shoulder bone-block shows satisfactory results in terms of pain relief [10].
The iliac posterior shoulder bone-block shows satisfactory results in terms of function recovery [10].

Key Evidence

[L4] Additional long-term randomized trials comparing these positions are needed to better understand the potential advantages and disadvantages of surgical positioning for posterior shoulder stabilization. [1] (10.1177/2325967118822452)
[L4] At a minimum of 2 years successful correction of scapular anatomy can improve static subluxation and restore subjective and objective shoulder stability. [2] (10.1016/j.jseint.2025.06.018)
[L4] The thresholds defined in this study can provide a guideline for interpreting patient outcomes following arthroscopic stabilization for posterior shoulder instability, allowing for earlier detection of recurrent posterior instability. [3] (10.1016/j.jseint.2025.08.006)
[L1] The early and midterm results of arthroscopic stabilization of the shoulder for posterior instability are promising. [4] (10.1016/j.arthro.2014.11.009)
[L5] Recurrent posterior shoulder instability is an uncommon condition often unrecognized, leading to incorrect diagnoses and delays. [5] (10.5435/00124635-200608000-00004)
[L5] Over the past several centuries, a number of procedures have been developed to address posterior shoulder instability, particularly as this pathology has become better understood. [6] (10.1016/j.jses.2019.08.008)
[L3] Coracoid morphology differs significantly in patients undergoing posterior shoulder stabilization when compared to patients undergoing surgery for anterior instability or a comparison cohort. [7] (10.1177/03635465261421534)
[L4] Arthroscopic management of posterior-inferior shoulder instability has a successful track record and minimal complication profile. [8] (10.1016/j.arthro.2018.06.057)
[L5] The article outlines the evolution of diagnostic acumen and treatment algorithms for posterior shoulder instability, emphasizing that arthroscopic surgical techniques have facilitated successful management of both recurrent posterior subluxations and frank posterior instability. [9] (10.1016/j.csm.2008.06.001)
[L4] The iliac posterior shoulder bone-block is effective in managing instances of involuntary posterior shoulder instability, showing satisfactory results in terms of non-recurrence, pain relief, and function recovery. [10] (10.1016/j.otsr.2008.09.008)
[L4] Overall, male patients were significantly more likely to have anterior shoulder instability, while female patients were significantly more likely to have posterior shoulder instability. [11] (10.1177/23259671211006437)
[L1] Posterior bone block augmentation for recurrent posterior shoulder instability does not reliably yield substantial improvements in patient-reported outcomes, and complications are frequently observed. [12] (10.1016/j.arthro.2021.07.018)
[L4] There is a moderate rate of recurrence following posterior bone block for posterior shoulder instability. [13] (10.1016/j.jse.2021.06.013)
[L4] Arthroscopic stabilization of posterior shoulder instability resulted in good outcomes with high patient satisfaction and low rates of recurrent instability, revisions, and residual pain. [14] (10.1016/j.jse.2024.04.006)
[L4] There is a high rate of return to sport after arthroscopic posterior shoulder stabilization, ranging from 4.3 to 8.6 months after surgery. [15] (10.1016/j.asmr.2020.08.007)
[L5] Advances in understanding posterior glenohumeral anatomy and biomechanics have improved comprehension of this challenging disorder and helped guide clinical decision making, including delineation of surgical indications and contraindications, nonsurgical treatment solutions, and appropriate stabilization and bone augmentation techniques. [16] (10.5435/jaaos-d-15-00631)
[L5] This review guides the reader to correctly identify posterior shoulder instability (PSI) by providing diagnostic criteria and treatment strategies based on the ABC classification, which distinguishes three groups of PSI based on the nature of pathology and two subtypes based on pathomechanical causes. [17] (10.1530/eor-24-0025)
[L4] Overall, reduction was achieved via open means in the majority of shoulders, and delayed diagnosis is common. [18] (10.1302/0301-620x.101b1.bjj-2018-0984.r1)
[L3] Regardless of the radiologist interpretation of MRA, patients with symptomatic posterior shoulder instability do benefit from arthroscopic stabilization surgery. [19] (10.1016/j.xrrt.2026.100675)
[L5] In patients with suspected posterior glenohumeral instability, imaging of the affected shoulder can show abnormalities of the bone, labrum, and joint capsule. [20] (10.2214/ajr.07.3849)
[L4] Participants with microtraumatic posterior shoulder instability demonstrated significant improvements in patient-reported outcome measures and high rates of return to sport following a 24-week conservative rehabilitation program. [21] (10.1016/j.jseint.2024.09.016)
[L1] Both glenoid osteotomy and bone block procedures can successfully address symptomatic posterior shoulder instability. [22] (10.1016/j.xrrt.2025.03.004)
[L4] The systematic review demonstrated high rates of return to sport and relatively high rates of return to preinjury level of sport among all athletes who underwent surgical treatment for posterior shoulder instability. [23] (10.1016/j.jseint.2020.08.002)
[L5] Glenoid as well as acromial malalignment alone is associated with pathological posterior translation of the humeral head across the glenoid upon simulated active elevation. [24] (10.1177/03635465251411312)
[L5] Glenohumeral contact patterns highly depend on the amount of glenoid retroversion and posterior labral and/or bony glenoid integrity. [25] (10.1177/03635465251365497)
[L5] The PPS injury produces alterations in GH kinematics with implications for GH joint instability, increased GH joint loading, and potential joint damage. [26] (10.1016/j.jse.2024.12.023)
[L5] The acromion acts as a mechanical buttress to posterior humeral head displacement. [27] (10.1016/j.jse.2024.09.047)
[L5] The long head of the biceps has a pertinent biomechanical role in glenohumeral stability regardless of the condition of the superior labrum. [28] (10.1016/j.arthro.2025.05.022)
[L4] Bilateral posterior shoulder dislocations with reverse Hill-Sachs lesions are uncommon and prone to misdiagnosis; early recognition and tailored treatment strategies are essential for satisfactory functional outcomes. [30] (10.1186/s12891-026-09537-y)
[L3] Patients with C1 shoulders differ from healthy controls regarding osseous scapular and humeral morphology, scapulothoracic orientation, and shoulder girdle muscle distribution. [31] (10.1177/03635465241233706)
[L4] NHL team physicians strongly favor nonoperative management in-season for initial posterior instability events of the shoulder. [32] (10.1177/23259671261440208)
[L5] Surgical treatment must balance the necessity to repair torn capsulolabral tissues with the tendency to over constrain the shoulder. [34] (10.5435/jaaos-d-19-00535)
[L4] Arthroscopic posterior Bankart repair for traumatic posterior shoulder instability in collision sports athletes resulted in a low recurrence rate, high return-to-play rate, and clinically meaningful improvement. [35] (10.1016/j.asmr.2025.101264)
[L4] In such cases, anatomical reduction and retention of the acromion fracture may be needed to prevent recurrent posterior instability. [37] (10.1016/j.xrrt.2025.09.006)
[L4] Anterior greater tuberosity malunion after posterior shoulder fracture dislocation is a rare and debilitating condition. [38] (10.1016/j.xrrt.2024.12.002)
[L4] However, the high rate of persistent instability should be considered when making treatment decisions. [40] (10.1177/17585732211056053)

References

[1] Outcomes of Arthroscopic Posterior Shoulder Stabilization in the Beach-Chair Versus Lateral Decubitus Position: A Systematic Review. Orthopaedic Journal of Sports Medicine. 2019. DOI: 10.1177/2325967118822452

[2] Scapular (glenoid and acromion) osteotomies for the treatment of posterior shoulder instability: technique and preliminary results. JSES International. 2025. DOI: 10.1016/j.jseint.2025.06.018

[3] Defining clinical significance following primary stabilization of posterior shoulder instability. JSES International. 2025. DOI: 10.1016/j.jseint.2025.08.006

[4] Arthroscopic Treatment of Posterior Shoulder Instability: A Systematic Review. Arthroscopy. 2014. DOI: 10.1016/j.arthro.2014.11.009

[5] Recurrent Posterior Shoulder Instability. Journal of the American Academy of Orthopaedic Surgeons. 2006. DOI: 10.5435/00124635-200608000-00004

[6] History of surgical stabilization for posterior shoulder instability. JSES Open Access. 2019. DOI: 10.1016/j.jses.2019.08.008

[7] Coracoid Morphology and the Risk of Posterior Shoulder Instability: A Magnetic Resonance Imaging Study. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261421534

[8] Patient Positioning in Arthroscopic Management of Posterior‐Inferior Shoulder Instability: A Systematic Review Comparing Beach Chair and Lateral Decubitus Approaches. Arthroscopy. 2018. DOI: 10.1016/j.arthro.2018.06.057

[9] Arthroscopic Management of Posterior Shoulder Instability: Diagnosis, Indications, and Technique. Clinics in Sports Medicine. 2008. DOI: 10.1016/j.csm.2008.06.001

[10] Iliac bone-block autograft for posterior shoulder instability. Orthopaedics & Traumatology: Surgery & Research. 2009. DOI: 10.1016/j.otsr.2008.09.008

[11] Differences in Outcomes Between Anterior and Posterior Shoulder Instability After Arthroscopic Bankart Repair: A Systematic Review and Meta-analysis. Orthopaedic Journal of Sports Medicine. 2021. DOI: 10.1177/23259671211006437

[12] Bone Block Augmentation of the Posterior Glenoid for Recurrent Posterior Shoulder Instability Is Associated With High Rates of Clinical Failure: A Systematic Review. Arthroscopy. 2021. DOI: 10.1016/j.arthro.2021.07.018

[13] Posterior glenoid bone block transfer for posterior shoulder instability: a systematic review. Journal of Shoulder and Elbow Surgery. 2021. DOI: 10.1016/j.jse.2021.06.013

[14] Outcomes of arthroscopic stabilization for posterior shoulder instability: a systematic review. Journal of Shoulder and Elbow Surgery. 2024. DOI: 10.1016/j.jse.2024.04.006

[15] Return to Play After Arthroscopic Stabilization for Posterior Shoulder Instability—A Systematic Review. Arthroscopy, Sports Medicine, and Rehabilitation. 2020. DOI: 10.1016/j.asmr.2020.08.007

[16] Posterior Glenohumeral Instability: Evidence-based Treatment. Journal of the American Academy of Orthopaedic Surgeons. 2017. DOI: 10.5435/jaaos-d-15-00631

[17] Diagnosis and treatment of posterior shoulder instability based on the ABC classification. EFORT Open Reviews. 2024. DOI: 10.1530/eor-24-0025

[18] The aetiology of posterior glenohumeral dislocations and occurrence of associated injuries. The Bone & Joint Journal. 2019. DOI: 10.1302/0301-620x.101b1.bjj-2018-0984.r1

[19] No difference in outcomes for posterior shoulder instability surgery in patients with a normal vs. pathological radiologist reported magnetic resonance arthrogram study. JSES Reviews, Reports, and Techniques. 2026. DOI: 10.1016/j.xrrt.2026.100675

[20] Imaging Signs of Posterior Glenohumeral Instability. American Journal of Roentgenology. 2009. DOI: 10.2214/ajr.07.3849

[21] The efficacy of conservative management of micro-traumatic posterior shoulder instability. JSES International. 2025. DOI: 10.1016/j.jseint.2024.09.016

[22] Posterior shoulder instability – A systematic review and meta-analysis of glenoid osteotomy and bone block procedures. JSES Reviews, Reports, and Techniques. 2025. DOI: 10.1016/j.xrrt.2025.03.004

[23] Return to sport after surgical treatment for posterior shoulder instability: a systematic review. JSES International. 2020. DOI: 10.1016/j.jseint.2020.08.002

[24] Scapular Morphology and Posterior Shoulder Stability: Biomechanical Evidence From an Advanced Cadaveric Shoulder Simulator. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465251411312

[25] Correcting Excessive Glenoid Retroversion in Combination With Posterior Glenoid Bone Grafting Leads to Improved Glenohumeral Contact Pressures in a Cadaveric Posterior Instability Model. The American Journal of Sports Medicine. 2025. DOI: 10.1177/03635465251365497

[26] 2025 Basic Science Neer Award Winner: The impact of posterior and posterior superior labral injuries and the effect of their treatment on glenohumeral kinematics in the deceleration and follow-through phase of throwing: a biomechanical study. Journal of Shoulder and Elbow Surgery. 2025. DOI: 10.1016/j.jse.2024.12.023

[27] Posterior shoulder stability depends on acromial anatomy: a cadaveric, biomechanical study. Journal of Shoulder and Elbow Surgery. 2025. DOI: 10.1016/j.jse.2024.09.047

[28] Biceps Tenodesis/Tenotomy Disrupts Biomechanical Glenohumeral Stability in the Setting of Superior Labrum Anteroposterior Tear and Repair. Arthroscopy. 2025. DOI: 10.1016/j.arthro.2025.05.022

[30] Bilateral posterior shoulder dislocations with reverse Hill-Sachs lesions: a report of two cases and a literature review. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09537-y

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