Nonoperative Management of Posterior Shoulder Instability: What Are the Long-Term Clinical Outcomes?

Julia Lee, Jarret M. Woodmass, Christopher D. Bernard, Devin P. Leland, Lucas K. Keyt, Aaron J. Krych, DIane L. Dahm, Christopher L. Camp

Research output: Contribution to journalArticlepeer-review


Objective:To report the injury characteristics, radiographic findings, and long-term outcomes of nonoperative management for posterior shoulder instability (PSI).Design:A retrospective review of 143 patients with PSI using a large geographic database.Setting:Single county between January 1994 and July 2012.Patients:A clinical history and diagnosis of PSI, one confirmatory imaging study to support the diagnosis, and a minimum of 5 years follow-up were required for inclusion. Patients with seizure disorders, anterior-only instability, multidirectional instability, and superior labrum from anterior to posterior diagnosis were excluded.Interventions:Patients with PSI were managed nonoperatively or operatively.Main Outcome Measures:Pain, recurrent instability, and progression into glenohumeral osteoarthritis at long-term follow-up.Results:One hundred fifteen patients were identified. Thirty-seven (32%) underwent nonoperative management. Twenty (54%) patients were diagnosed with posterior subluxation, 3 (8%) with a single dislocation, and 7 (19%) with multiple dislocations. Symptomatic progression of glenohumeral arthritis was observed in 8% (3) of patients. Pain improved in 46% (17) of patients and worsened in 19% (7). Recurrent instability and progression to osteoarthritis occurred in 15% (3/20) of patients with a traumatic instability event compared with 0% of atraumatic patients after nonoperative management (P = 0.234). Pain at follow-up was more common in nonoperative than operative patients (P = 0.017).Conclusions:Nonoperative management is a viable option for many patients with posterior shoulder instability; however, many may continue to have posterior shoulder pain.

Original languageEnglish (US)
Pages (from-to)E116-E120
JournalClinical Journal of Sport Medicine
Issue number2
StatePublished - Mar 1 2022


  • nonoperative treatment
  • posterior labral tear
  • posterior labrum
  • posterior shoulder dislocation
  • posterior shoulder instability

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation


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