The Surgeons’ Dilemma: Revision Instability in the Athlete

Management of the athlete who has failed one or more prior primary shoulder stabilization procedures is a great challenge for the orthopaedic surgeon. With the risk of recurrence of instability being greater in the revision setting, a systematic approach to treat these patients is of great importance. This article will discuss the causes of recurrent shoulder instability, including improper diagnosis, ligamentous laxity, and technical errors and the various treatment options that should be explored. An algorithm for the treatment of athletes with recurrence of instability following a failed primary shoulder stabilization procedure will be presented to help the surgeon in determining the best mode of treatment for their patients.