Shoulder Instability: Arthroscopic Capsulolabral Repair: the Gold Standard

There still exists some skepticism in the orthopedic community regarding the effectiveness of all-arthroscopic shoulder stabilization surgeries, mostly due to older literature, which report high failure rates when compared to open surgery. We look to present the modern indications and techniques of arthroscopic shoulder stabilization and highlight recent studies which show equivalent or superior results even in the contact athlete. There exists an abundance of literature which shows arthroscopic shoulder stabilization done with proper anchor placement, incorporating capsulolabral shifts, with the patient positioned in lateral decubitus position provides for superior outcomes. It is also critical to recognize and address concomitant lesions of instability at the time of surgery to further reduce surgical failures. We contend that there still exists a role for open stabilizations especially in the setting of significant glenoid bone loss or in the revision setting, however for the majority of stabilization procedures, arthroscopic technique is the gold standard.