Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Dec 18, 2015; 6(11): 927-934
Published online Dec 18, 2015. doi: 10.5312/wjo.v6.i11.927
Posterior shoulder instability in the athletic population: Variations in assessment, clinical outcomes, and return to sport
Jeffrey M DeLong, James P Bradley
Jeffrey M DeLong, Medical University of South Carolina, Charleston, SC 29403, United States
James P Bradley, Burke and Bradley Orthopedics, University of Pittsburgh Medical Center, Pittsburgh, PA 15215, United States
Author contributions: DeLong JM and Bradley JP both equally designed the research; DeLong JM and Bradley JP both equally performed research; DeLong JM and Bradley JP both equally analyzed data; DeLong JM and Bradley JP both equally wrote the paper.
Conflict-of-interest statement: There is no conflict of interest associated with the senior author or other coauthors contributed efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. James P Bradley, Burke and Bradley Orthopedics, University of Pittsburgh Medical Center, St. Margaret 200 Medical Arts Building, Suite 4010 200 Delafield Road, Pittsburgh, PA 15215, United States.
Telephone: +1-412-7845770 Fax: +1-412-7845776
Received: May 29, 2015
Peer-review started: June 3, 2015
First decision: July 3, 2015
Revised: July 29, 2015
Accepted: October 20, 2015
Article in press: October 27, 2015
Published online: December 18, 2015

Posterior instability of the shoulder is becoming an increasingly recognized shoulder injury in the athletic population. Diagnostic elements, such as etiology, directionality, and degree of instability are essential factors to assess in the unstable athletic shoulder. Concomitant injuries and associated pathologic lesions continue to be a significant challenge in the surgical management of posterior shoulder instability. Return to sport and previous level of play is ultimately the goal for every committed athlete and surgeon, thus subpopulations of athletes should be recognized as distinct entities requiring unique diagnostic, functional outcome measures, and surgical approaches.

Keywords: Posterior shoulder instability, Overhead throwing athletes, Contact athletes

Core tip: This article focuses on important posterior shoulder instability diagnostic criteria, effects of concomitant injuries, discussion of variations in athletic subpopulations and effects of return to sport, surgical management and advantages of arthroscopic vs open techniques.