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The Journal of Bone and Joint Surgery (American) 85:2145-2146 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Commentary

The Diagnostic Definition of Multidirectional Instability of the Shoulder: Searching for Direction

Robin R. Richards, MD, FRCSC, Deputy Editor for the Upper Extremity

The first 150 words of the full text of this article appear below.

The article by McFarland et al.1 represents a provocative call to action. Most clinicians agree that there is a group of patients with markedly symptomatic shoulder instability in more than one direction. There is also general agreement that this group is difficult to treat, that the patients are less likely to benefit from surgical intervention than are other patients with shoulder instability, and that the primary pathological entity in this group is capsular laxity. Use of the term multidirectional shoulder instability when describing these patients has achieved wide acceptance. Although there is consensus regarding the concept of multidirectional instability, the innovative investigation performed by McFarland et al. demonstrates that the literature on the subject is flawed.

Multiple diagnostic definitions have been used for this patient group. Problems in the current literature include inconsistent, sometimes unclear definitions of the condition and variability in the number of directions required in order to . . . [Full Text of this Article]


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 Am J Sports MedHome page
J. B. Ogston and P. M. Ludewig
Differences in 3-Dimensional Shoulder Kinematics Between Persons With Multidirectional Instability and Asymptomatic Controls
Am. J. Sports Med., August 1, 2007; 35(8): 1361 - 1370.
[Abstract] [Full Text] [PDF]