SHOULDER INSTABILITY
Anterior Shoulder
Instability
Anterior shoulder instability occurs when the ball of the shoulder slips out the front of the socket. It is the most common direction of shoulder instability and often follows a traumatic dislocation during sports, a fall, or another high-energy injury.
Front Of Socket
Traumatic Dislocation
Bankart • Hill-Sachs • Bone Loss
Long-Term Stability
What Is Anterior Shoulder Instability?
Anterior instability means the humeral head slips forward out of the glenoid socket. This may be a complete dislocation or a partial slipping episode called a subluxation.
During an anterior dislocation, the labrum, ligaments, cartilage, and bone may be injured. The specific injury pattern determines whether physical therapy, arthroscopic Bankart repair, Bankart repair with remplissage, or Latarjet surgery is most appropriate.
Dr. Streit’s Clinical Perspective
Anterior instability is not one diagnosis. It is a pattern of injury. I look at the patient’s age, sport, number of dislocations, labral injury, glenoid bone loss, Hill-Sachs lesion, and goals before recommending treatment.
Common Symptoms
Dislocation
The shoulder completely comes out of place.
Subluxation
The shoulder partially slips and then returns.
Apprehension
The shoulder feels unsafe in overhead or externally rotated positions.
Pain
Pain often follows instability episodes or athletic activity.
Loss Of Confidence
Patients avoid sports, lifting, or positions that feel unstable.
Recurrent Episodes
The shoulder may dislocate more easily over time.
Important Associated Injuries
Bankart Tear
A tear of the front labrum that often occurs after anterior dislocation.
Hill-Sachs Lesion
A compression injury in the humeral head caused by the dislocation.
Glenoid Bone Loss
Loss of bone from the front of the socket, which may make soft-tissue repair less reliable.
How Is It Diagnosed?
Diagnosis begins with the history of the instability event and a focused physical examination. X-rays evaluate the joint and identify fractures. MRI helps evaluate the labrum, ligaments, and rotator cuff. CT scan may be used when bone loss is suspected.
Treatment Options
Physical Therapy
May be appropriate after selected first-time dislocations or lower-risk instability patterns.
Bankart Repair
Repairs the torn anterior labrum when bone loss is not the dominant problem.
Latarjet Procedure
Often recommended when bone loss or high-risk instability features make soft-tissue repair less reliable.
What I Tell My Patients
“The first goal is to understand why your shoulder is unstable. The operation should be chosen for your shoulder’s specific instability pattern—not simply because an MRI shows a labral tear.”
Related Resources
Shoulder Slipping Out The Front?
A detailed shoulder instability evaluation can identify the injury pattern and determine whether rehabilitation, Bankart repair, remplissage, or Latarjet surgery offers the best chance of long-term stability.
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