Portal Closure After Segmental Posterior Labral Repair for Posterior Shoulder Instability
Victor J. Yu, M.S., John P. Taliaferro, M.D., and Kevin F. Bonner, M.D.
Abstract
Posterior instability, although an uncommon shoulder pathology, is reported most frequently in the athletic population. Arthroscopic repair has emerged as the main surgical treatment modality for posterior instability. However, when compared with arthroscopic repair for anterior instability, the results of this procedure remain suboptimal. The creation of iatrogenic defects in the capsule, due to cannula placement, is a possible culprit. Because these defects typically do not heal satisfactorily, they become stress risers within the capsule itself, which may lead to recurrent instability or an otherwise compromised repair construct. Therefore, we find that routine intraoperative repair of these defects after repair can reduce the risk of injury and possibly improve long-term outcomes. In this article, we illustrate the repair of a posterior segmental tear using all-suture knotless implants with closure of the posterior and posterior-inferior portals after stabilization.
Posterior instability is observed less frequently compared with its anterior counterpart, with pos- terior instability comprising between 2% and 12% of all shoulder instability cases.1 Posterior instability is more commonly reported in athletes involved in activities with highly repetitive loads and posteriorly directed forces, such as rock climbers, football linemen, wres-tlers, and weight lifters.
