Arthroscopic Treatment for Multidirectional Instability

作者：O' Brien Michael; Savoie Felix H III^*

来源：Operative Techniques in Sports Medicine, 2014, 22(1): 25-33.

DOI：10.1053/j.otsm.2014.02.004

• multidirectional instability
• shoulder laxity
• rotator interval

Multidirectional instability (MDI) was first described by Neer and Foster in 1980. Although there has been much confusion over the years with a blending of classifications, the inherent concept of symptomatic inferior instability with associated anterior and posterior instability remains the hallmark of the MDI shoulder. The MDI shoulder may be thought of as one of compensation, where the balance of the scapula and rotator cuff maintain the humeral head in the glenoid. Symptoms are seen when this balance is lost. The anatomical characteristic of the MDI shoulder is increased capsular volume with widening of the critical rotator interval structures (superior glenohumeral ligament and coracohumeral ligament) along with dysfunction of the entire inferior glenohumeral ligament complex. %26lt;br%26gt;Management centers on nonoperative treatment, with pain control and scapular rebalancing exercises being the key to successful nonoperative management. Surgery is only indicated by a failure of nonoperative treatment and is focused on closing the rotator interval and decreasing capsular volume by shifting both the anterior and posterior capsule superiorly.

• 出版日期2014-3