Information for Patients

Multidirectional shoulder instability (MDI) is a challenging entity for the clinician to treat. The presenting complaint may range from pain to episodes of subluxation or dislocation in the affected shoulder. There is often no history of major trauma or only minor trauma. Athletes involved in repetitive overhead activities are often affected, as are patients with generalized ligamentous laxity. The mainstay of treatment of MDI is conservative, with a focus on physical therapy. Patients whose symptoms are refractory to conservative measures may benefit from surgical treatment. Traditionally, MDI has been treated with an open capsular shift. More recent reports have described successful arthroscopic capsular plication techniques. This article reviews the diagnosis and treatment options for MDI, and the technique of arthroscopic capsular plication is reviewed in detail.