Surgical management of posterior instability in the athlete

The surgical treatment of posterior glenohumeral instability in the athlete is a challenge. The logical and step-wise approach to evaluation, rehabilitation, and surgical intervention, when necessary, will allow the best chance for success for restoration of stability and return to premorbid activity levels. The relatively uncommon occurrence of recurrent posterior instability, compared with anterior instability, is reflected in the smaller number of series with smaller numbers of patients in the literature. The variety of surgical approaches, both open and arthroscopic, can make choosing the best surgical option difficult. This article reviews the pathophysiology of posterior instability in the athlete. Open and arthroscopic approaches and thermal shrinkage in the treatment of posterior instability in the athlete win be discussed.