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Estalos, estalidos e instabilidade no ombro

Why a shoulder clicks, pops or feels like it slips — from harmless noises to labral tears and instability — what it means, and when it needs attention.

Updated Aug 2026
Uma pessoa com os braços cruzados segurando ambos os ombros.
Estalos, estalidos ou a sensação de deslocamento do ombro podem indicar instabilidade que merece avaliação. Kieran Hirpara 4.0

Esta página foi traduzida automaticamente e ainda não foi verificada por um médico. A versão em inglês é a versão oficial.

O que você está sentindo

Você pode notar estalos, estalidos ou uma sensação de atrito no ombro. Isso geralmente ocorre quando a articulação parece frouxa ou instável. A dor costuma ser profunda no ombro e pode irradiar para baixo pelo braço. Frequentemente, piora após você levantar objetos pesados ou alcançar acima da cabeça. Você também pode sentir desconforto ao dormir de lado sobre esse ombro, dificultando o descanso à noite.

As tarefas diárias podem se tornar desafiadoras. Movimentos simples, como alcançar as costas para fechar um sutiã ou abotoar uma camisa, podem causar dor aguda ou a sensação de que o ombro está escapando do lugar. Alcançar itens em prateleiras altas pode desencadear instabilidade. Você pode evitar usar o braço completamente por medo de que ele se desloque. Essa hesitação pode fazer você se sentir fraco ou descoordenado durante as atividades rotineiras.

Para alguns, os sintomas pioram com esportes ou atividades físicas específicas. Se você tiver instabilidade multidirecional, seu ombro pode parecer frouxo em várias direções. Em casos graves, a articulação pode se deslocar parcial ou totalmente. Isso é uma emergência médica que requer atenção imediata. Se você experimentar uma dor súbita e intensa e incapacidade de mover o ombro, procure atendimento imediatamente.

Seu cirurgião dependerá de um exame físico minucioso para entender seus sintomas específicos. Exames de imagem, como a ressonância magnética (MRI), podem mostrar problemas estruturais, mas sua experiência física é o guia mais importante para o tratamento. Seja você tiver instabilidade anterior ou posterior, o objetivo é reduzir essas sensações desconfortáveis e restaurar a estabilidade. Compreender o que desencadeia seus sintomas ajuda seu cirurgião a criar um plano personalizado para suas necessidades.

O que está realmente acontecendo

Seu ombro é uma articulação do tipo bola e soquete. A bola é a parte superior do seu úmero. O soquete é uma cavidade rasa na sua escápula. Um anel de cartilagem chamado lábio glenoidal reveste esse soquete. Pense no lábio como uma junta ou um amortecedor. Ele aprofunda o soquete para que a bola permaneça no lugar. Ele também cria um selamento firme que mantém a articulação unida.

Quando você experimenta estalos, estalidos ou instabilidade, algo nesse sistema não está se encaixando corretamente. Em alguns casos, a forma do seu osso da escápula é diferente. Isso pode tornar a articulação menos estável. O próprio lábio pode estar rompido ou distendido. Se o lábio estiver danificado, não consegue manter a bola firmemente. Isso permite que a bola deslize ou saia do lugar. Você pode sentir isso como um deslocamento súbito ou uma sensação de atrito.

Às vezes, o problema envolve os ligamentos. Estes são fortes faixas de tecido que atuam como cordas segurando a articulação unida. Se um ligamento se desprender do osso, o ombro fica frouxo. Isso pode acontecer após uma luxação. Também pode acontecer se a cartilagem se desgastar com o tempo. Quando o revestimento liso nos ossos desaparece, as superfícies esfregam uma contra a outra. Isso causa dor e aquele som de estalo que você ouve.

Em casos graves, os próprios ossos podem mudar de forma. Uma depressão pode se formar na bola do ombro ao atingir o soquete. Isso torna mais difícil para a bola voltar ao lugar. Seu cirurgião observa essas alterações estruturais para entender por que seu ombro parece instável. Eles verificam se o lábio, os ligamentos ou os ossos são a causa principal. Entender isso os ajuda a escolher o tratamento certo para restaurar a estabilidade e parar os estalos.

O que podemos fazer a respeito

Em nossa clínica, o Dr. Kieran Hirpara orienta os pacientes por esse processo, iniciando com uma avaliação minuciosa para confirmar a causa dos seus sintomas. Geralmente, recomendamos o tratamento não operatório primeiro para problemas de longa data, reservando a cirurgia para casos em que o tratamento conservador não proporcionou alívio suficiente.

A maioria dos eventos iniciais de instabilidade do ombro é gerenciada sem cirurgia. Seu cirurgião provavelmente recomendará o tratamento não operatório, especialmente se você for atleta durante a temporada. Essa abordagem dá ao seu ombro a chance de cicatrizar e estabilizar por conta própria.

A fisioterapia é o núcleo deste tratamento. Ela visa melhorar a amplitude de movimento e a força funcional do seu ombro. Para alguns pacientes, a adição de bandagem kinesiológica à reabilitação convencional leva a melhorias mais significativas do que a terapia isolada. Você deve dar uma chance justa a esse tratamento conservador. Isso permite que seus músculos aprendam a proteger a articulação durante as atividades diárias e esportivas.

Se a dor persistir, seu cirurgião pode discutir o manejo médico. Isso geralmente envolve medicamentos para dor e anti-inflamatórios para reduzir o inchaço e o desconforto. Em alguns casos, podem ser oferecidas injeções, como cortisona, ácido hialurônico ou plasma rico em plaquetas (PRP). Essas injeções podem ajudar a acalmar a inflamação e proporcionar alívio temporário. A duração desse alívio varia de pessoa para pessoa, mas geralmente é de curto prazo. Isso ajuda você a participar da fisioterapia com mais conforto.

A cirurgia é considerada quando o tratamento conservador atinge seu limite. Isso geralmente significa que você teve luxações recorrentes ou instabilidade persistente apesar da reabilitação completa. Seu cirurgião avaliará sua anatomia específica, incluindo a quantidade de perda óssea e a posição de qualquer lesão. Se a cirurgia for necessária, o objetivo é reparar as estruturas danificadas e restaurar a estabilidade. O procedimento específico depende se a instabilidade é anterior ou posterior e se há perda óssea significativa.

Para casos complexos com perda óssea grave ou dano articular em estágio terminal, opções cirúrgicas mais avançadas podem ser discutidas. Estas podem incluir procedimentos de bloco ósseo ou, em raros casos de estágio terminal, fusão articular ou substituição. No entanto, a maioria dos pacientes encontra sucesso com o manejo não operatório ou com a cirurgia padrão de estabilização. Seu cirurgião o guiará pelo processo de tomada de decisão com base no seu exame clínico e nos resultados de imagem.

O que esperar

O seu prognóstico depende em grande parte de se a instabilidade do ombro é um evento único ou um padrão recorrente. Se esta é a sua primeira vez a experimentar instabilidade posterior, especialmente se ocorrer durante a época desportiva, o seu cirurgião provavelmente recomendará cuidados não cirúrgicos em primeiro lugar. Esta abordagem dá ao seu ombro a melhor hipótese de estabilizar sem a necessidade imediata de uma operação. Muitas pessoas verificam que os sintomas melhoram com repouso e terapia direcionada, permitindo-lhes regressar às suas atividades com segurança.

Se a sua instabilidade for recorrente ou grave, pode ser necessária cirurgia para restaurar a estabilidade. Para muitos pacientes, tanto as abordagens cirúrgicas artroscópicas como as abertas oferecem resultados semelhantes a longo prazo em termos de redução de luxações e melhoria da função. No entanto, os resultados variam consoante a natureza específica da sua lesão. Por exemplo, se tiver perda óssea significativa ou certos tipos de lesões do lábio, o risco de o ombro voltar a luxar é maior. Nestes casos complexos, as reparações isoladas podem não proporcionar estabilidade duradoura, e os resultados relatados pelos pacientes podem diminuir ao longo do tempo. O seu cirurgião analisará atentamente a sua idade, o tipo de lesão tecidual e a localização da lesão para prever o seu risco pessoal de recorrência.

A recuperação é um processo gradual que requer paciência. Embora muitos pacientes apresentem resultados clínicos favoráveis após a reparação, o cronograma para regressar à participação total nas atividades desportivas permanece incerto para alguns procedimentos. Pode notar uma melhoria constante na força e na confiança ao longo de vários meses. Nos casos que envolvem condições complexas, como a síndrome de Ehlers-Danlos ou o desgaste articular em estágio terminal, podem ser discutidas como opções viáveis procedimentos mais extensos, como a fusão articular ou a substituição, para eliminar a dor e prevenir novas luxações. Um exame físico minucioso é a etapa mais crítica para determinar o caminho certo para si, uma vez que os resultados das imagens por si só nem sempre contam a história completa. Ao compreender os seus riscos específicos e trabalhar em estreita colaboração com a sua equipa de cuidados, pode definir expectativas realistas para um ombro estável e funcional.

Quando procurar um especialista

Procure uma avaliação especializada se apresentar dor persistente que não melhora com o repouso, ou se o ombro parecer fraco e instável. Consulte o seu médico de família se a articulação bloquear ou ceder durante as atividades diárias. Procure atendimento se os sintomas interferirem no seu sono ou no trabalho. A piora súbita da instabilidade requer atenção imediata. Um exame clínico detalhado é o fator mais importante para determinar se é necessária cirurgia. O reconhecimento precoce de problemas, como luxações recorrentes, é essencial para obter resultados funcionais satisfatórios. Não espere que os sintomas se resolvam espontaneamente se persistirem.


Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Coracoid morphology differs significantly in patients undergoing posterior shoulder stabilization compared to patients undergoing surgery for anterior instability or a comparison cohort [1].
  • NHL team physicians strongly favor nonoperative management in-season for initial posterior instability events of the shoulder [2].
  • Contemporary studies show comparable instability and functional outcomes between arthroscopic and open Bankart repair approaches, whereas historical differences were driven primarily by earlier studies [3].
  • Rates of recurrent anterior shoulder instability were high following isolated arthroscopic Bankart repair for on-track Hill-Sachs lesions with <20% glenoid bone loss [4].
  • High rates of recurrent anterior shoulder instability following isolated arthroscopic Bankart repair for on-track Hill-Sachs lesions with <20% glenoid bone loss were associated with inferior PROs at mean 10-year follow-up [4].
  • There is no difference in outcomes for posterior shoulder instability surgery in patients with a normal vs. pathological radiologist reported magnetic resonance arthrogram study [5].
  • A thorough clinical exam is the most important factor when determining indication for shoulder instability surgery [5].
  • Open capsular shift with Achilles allograft augmentation demonstrated low rates of recurrent instability and improved clinical outcomes in patients with multidirectional shoulder instability, including those with Ehlers-Danlos syndrome [6].
  • Reverse shoulder arthroplasty and glenohumeral arthrodesis are viable options in treating end-stage recurrent shoulder instability [7].
  • Arthroscopic repair of posterior humeral avulsion of the glenohumeral ligament in recurrent anterior shoulder dislocations typically results in favorable clinical outcomes [9].
  • The likelihood of returning to sports remains uncertain following arthroscopic repair of posterior humeral avulsion of the glenohumeral ligament in recurrent anterior shoulder dislocations [9].
  • The modified Kouvalchouk procedure provides good results in the stabilization of recurrent posterior unstable shoulders in traumatic cases and patients without previous surgery [10].
  • The modified Kouvalchouk procedure offers the advantage of local harvesting of a bone block and a potential sling effect [10].
  • Spin is highly prevalent in abstracts of systematic reviews and meta-analyses investigating free bone block procedures for glenohumeral instability [11].

Anatomy & Pathophysiology

  • Labral morphology does not compensate for reduced bony glenoid concavity in clinically stable shoulders [17].
  • The labrum contributes significantly to joint depth and creates a more congruent joint by minimizing differences between humerus and glenoid radius of curvature (ROC) [21].
  • Healthy young adults exhibit deeper, thicker, and taller glenoid labrum morphology at the 12 o'clock position [21].
  • Bilateral posterior shoulder dislocations with reverse Hill-Sachs lesions are uncommon and prone to misdiagnosis [12].
  • Traumatic posterior shoulder dislocation can occur in association with a posterior acromion fracture [8].
  • Posterior humeral avulsion of the glenohumeral ligament (HAGL) can be present in recurrent anterior shoulder dislocations [9].
  • Acute anterior shoulder dislocation carries a risk of subsequent rotator cuff tear (RCT), for which risk prediction models exist [22].

Classification

  • Recurrent anterior shoulder instability following isolated arthroscopic Bankart repair for on-track Hill-Sachs lesions with <20% glenoid bone loss was associated with inferior patient-reported outcomes at mean 10-year follow-up [4].
  • There is no difference in outcomes for posterior shoulder instability surgery in patients with a normal versus pathological radiologist-reported magnetic resonance arthrogram study [5].
  • Open capsular shift with Achilles allograft augmentation demonstrates low rates of recurrent instability and improved clinical outcomes in high-risk patients with multidirectional shoulder instability, including those with Ehlers-Danlos syndrome [6].
  • The modified Kouvalchouk procedure provides good results in stabilizing recurrent posterior unstable shoulders in traumatic cases and patients without previous surgery [10].
  • Younger surgeons are more likely to incorporate the glenoid track concept into their decision-making for first-time anterior shoulder dislocation compared to older counterparts [13].
  • The Instability Severity Index Score and the Hill-Sachs interval-to-glenoid track ratio composite score showed good predictive performance for recurrence after arthroscopic Bankart repair [14].

Clinical Presentation

  • Contemporary studies show comparable instability and functional outcomes between arthroscopic and open Bankart repair approaches, whereas historical differences were driven by earlier studies [3].
  • A thorough clinical exam is the most important factor when determining the indication for shoulder instability surgery [5].
  • Reverse shoulder arthroplasty and glenohumeral arthrodesis are viable options for treating end-stage recurrent shoulder instability [7].
  • The likelihood of returning to sports after arthroscopic repair of posterior humeral avulsion of the glenohumeral ligament in recurrent anterior shoulder dislocations remains uncertain [9].
  • The modified Kouvalchouk procedure allows for local harvesting of a bone block and offers a potential sling effect [10].
  • Early recognition and tailored treatment strategies are essential for satisfactory functional outcomes in bilateral posterior shoulder dislocations with reverse Hill-Sachs lesions [12].
  • Younger surgeons are more likely to incorporate the glenoid track concept into their decision-making for managing a first-time anterior shoulder dislocation compared to older counterparts [13].
  • Similar return-to-play rates are seen with open versus arthroscopic anterior shoulder stabilization in contact and collision athletes [15].
  • Age, labral lesion type, and lesion location are key risk factors for recurrence following arthroscopic labrum repair in patients with anterior shoulder instability at a minimum 10-year follow-up [16].

Investigations

  • A thorough clinical exam is the most important factor when determining indication for shoulder instability surgery, with no difference in outcomes for posterior shoulder instability surgery in patients with a normal vs. pathological radiologist-reported magnetic resonance arthrogram study [5].

Treatment

  • Kinesio taping combined with conventional rehabilitation leads to more significant improvements in shoulder range of motion and functional scores compared to conventional rehabilitation alone in military personnel with recurrent shoulder dislocation caused by training injury [18].
  • Arthroscopic Bankart repair (ABR) for on-track Hill-Sachs lesions with <20% glenoid bone loss is associated with high rates of recurrent anterior shoulder instability and inferior patient-reported outcomes at mean 10-year follow-up [4].
  • The Instability Severity Index Score and the Hill-Sachs interval-to-glenoid track ratio composite score show good predictive performance for recurrence after ABR in patients with <20% glenoid bone loss [14].
  • Contemporary studies show comparable instability and functional outcomes between arthroscopic and open Bankart repair approaches for anterior shoulder instability, whereas historical differences were driven by earlier studies [3].
  • Return-to-play rates are similar between open and arthroscopic anterior shoulder stabilization in contact and collision athletes [15].
  • Arthroscopic distal tibial allograft reconstruction with suture button fixation and capsulolabral repair for traumatic anterior shoulder instability yields high rates of graft union and improves clinical outcomes at 2 years [19].
  • Arthroscopic bone block using an autologous iliac crest graft with concomitant remplissage results in a favorable outcome for a young patient with extensive sporting activity and severe bipolar bone loss [20].
  • The modified Kouvalchouk procedure provides good results in stabilizing recurrent posterior unstable shoulders in traumatic cases and patients without previous surgery, offering the advantages of local bone block harvesting and a potential sling effect [10].
  • Arthroscopic repair of posterior humeral avulsion of the glenohumeral ligament in recurrent anterior shoulder dislocations typically results in favorable clinical outcomes, though the likelihood of returning to sports remains uncertain [9].

Complications

  • High rates of recurrent anterior shoulder instability following isolated arthroscopic Bankart repair for on-track Hill-Sachs lesions with <20% glenoid bone loss were associated with inferior patient-reported outcomes at mean 10-year follow-up [4].
  • Open capsular shift with Achilles allograft augmentation for multidirectional shoulder instability demonstrated low rates of recurrent instability and improved clinical outcomes in patients with Ehlers-Danlos syndrome [6].

Recovery

  • Contemporary studies show comparable instability and functional outcomes between arthroscopic and open Bankart repair approaches [3].
  • Isolated arthroscopic Bankart repair for on-track Hill-Sachs lesions with <20% glenoid bone loss is associated with high rates of recurrent anterior shoulder instability [4].
  • Isolated arthroscopic Bankart repair for on-track Hill-Sachs lesions with <20% glenoid bone loss is associated with inferior patient-reported outcomes at mean 10-year follow-up [4].
  • Open capsular shift with Achilles allograft augmentation demonstrates low rates of recurrent instability and improved clinical outcomes in patients with multidirectional shoulder instability and Ehlers-Danlos syndrome [6].
  • The likelihood of returning to sports following arthroscopic repair of posterior humeral avulsion of the glenohumeral ligament remains uncertain [9].
  • The modified Kouvalchouk procedure provides good results for stabilizing recurrent posterior unstable shoulders in traumatic cases and patients without previous surgery [10].
  • The modified Kouvalchouk procedure allows for local harvesting of a bone block [10].
  • The modified Kouvalchouk procedure offers a potential sling effect [10].
  • The Instability Severity Index Score and the Hill-Sachs interval-to-glenoid track ratio composite score show good predictive performance for recurrence after arthroscopic Bankart repair [14].
  • Age is a key risk factor for recurrence following arthroscopic labrum repair in patients with anterior shoulder instability at a minimum 10-year follow-up [16].
  • Labral lesion type is a key risk factor for recurrence following arthroscopic labrum repair in patients with anterior shoulder instability at a minimum 10-year follow-up [16].
  • Lesion location is a key risk factor for recurrence following arthroscopic labrum repair in patients with anterior shoulder instability at a minimum 10-year follow-up [16].
  • Delayed inferior shoulder subluxation can occur secondary to incidental traumatic plexitis following arthroscopic rotator cuff repair [24].
  • Functional status in cases of delayed inferior shoulder subluxation secondary to incidental traumatic plexitis reflects the expected timeline of neurological reinnervation following C5-C6 plexitis [24].

Key Evidence

  • [L3] Coracoid morphology differs significantly in patients undergoing posterior shoulder stabilization when compared to patients undergoing surgery for anterior instability or a comparison cohort. [1] (10.1177/03635465261421534)
  • [L4] NHL team physicians strongly favor nonoperative management in-season for initial posterior instability events of the shoulder. [2] (10.1177/23259671261440208)
  • [L4] Publication period subgroup analysis suggests that historical instability differences were driven primarily by earlier studies, whereas contemporary studies show comparable instability and functional outcomes between approaches. [3] (10.1177/03635465261443999)
  • [L3] Rates of recurrent anterior shoulder instability were high following isolated ABR for on-track HSLs with <20% glenoid bone loss and were associated with inferior PROs at mean 10-year follow-up. [4] (10.1177/23259671261430742)
  • [L3] A thorough clinical exam is the most important factor when determining indication for shoulder instability surgery. [5] (10.1016/j.xrrt.2026.100675)
  • [L4] The study demonstrated low rates of recurrent instability and improved clinical outcomes in this high-risk population. [6] (10.1016/j.jse.2026.05.024)
  • [L2] TSA and GHA are viable options in treating end-stage recurrent shoulder instability. [7] (10.1016/j.jseint.2025.101429)
  • [L4] Two cases document an unusual injury pattern in which a posterior glenohumeral dislocation occurred in association with a (posterior) acromion fracture. [8] (10.1016/j.xrrt.2025.09.006)
  • [L4] While arthroscopic repair of this combination typically results in favorable clinical outcomes, the likelihood of returning to sports remains uncertain. [9] (10.1016/j.jse.2025.04.020)
  • [L4] The modified Kouvalchouk procedure provides good results in the stabilization of recurrent posterior unstable shoulders in traumatic cases and patients without previous surgery, with the advantage of local harvesting of a bone block and a potential sling effect. [10] (10.1016/j.jseint.2026.101681)
  • [L4] Spin is highly prevalent in abstracts of systematic reviews and meta-analyses investigating FBB for glenohumeral instability. [11] (10.1177/03635465251338079)
  • [L4] Bilateral posterior shoulder dislocations with reverse Hill-Sachs lesions are uncommon and prone to misdiagnosis; early recognition and tailored treatment strategies are essential for satisfactory functional outcomes. [12] (10.1186/s12891-026-09537-y)
  • [L5] Younger surgeons are more likely to incorporate the glenoid track concept into their decision-making compared to their older counterparts. [13] (10.1016/j.jse.2025.07.018)
  • [L3] The Instability Severity Index Score and the Hill-Sachs interval-to-glenoid track ratio composite score showed good predictive performance for recurrence after ABR. [14] (10.1002/arj.70009)
  • [L2] However, similar return‐to‐play rates are seen with either approach. [15] (10.1002/ksa.70263)
  • [L4] Age, labral lesion type, and lesion location are key risk factors for recurrence following arthroscopic labrum repair in patients with anterior shoulder instability at a minimum 10-year follow-up. [16] (10.1016/j.jse.2025.03.034)
  • [L4] This study demonstrates that labral morphology does not compensate for reduced bony glenoid concavity in clinically stable shoulders. [17] (10.1016/j.jseint.2025.101422)
  • [L4] The combined intervention of kinesio taping and conventional rehabilitation led to more significant improvements in shoulder range of motion and functional scores compared to conventional rehabilitation alone. [18] (10.1186/s12891-026-09753-6)
  • [L4] Arthroscopic DTA bone block glenoid reconstruction using 2 pairs of suture buttons to treat recurrent traumatic anterior instability with significant bone loss yields improved clinical and acceptable radiological outcomes. [19] (10.1002/arj.70008)
  • [Case_report] This case report demonstrates the efficacy of an arthroscopic Bankart with an arthroscopic bone augmentation of the anterior glenoid wall, in conjunction with an additional remplissage procedure, resulting in a favorable outcome for a young patient with extensive sporting activity. [20] (10.1016/j.xrrt.2025.100606)
  • [L4] The labrum contributed significantly to the depth and created a more congruent joint by minimizing differences between humerus and glenoid ROC. [21] (10.1002/arj.70221)
  • [L3] The findings may assist orthopedic surgeons in identifying patients at high risk for RCT after shoulder dislocation. [22] (10.1186/s12891-026-09550-1)
  • [L4] The case suggests that delayed inferior shoulder subluxation can occur secondary to incidental traumatic plexitis following arthroscopic rotator cuff repair, with functional status reflecting the expected timeline of neurological reinnervation following C5-C6 plexitis. [24] (10.1016/j.xrrt.2026.100754)

References

[1] Coracoid Morphology and the Risk of Posterior Shoulder Instability: A Magnetic Resonance Imaging Study. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261421534

[2] Treatment of Posterior Shoulder Instability in National Hockey League Players: A Survey of NHL Team Physicians. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671261440208

[3] Arthroscopic vs Open Bankart Repair for Anterior Shoulder Instability: A Systematic Review and Meta-analysis. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261443999

[4] Long-Term Outcomes following Instability After Isolated Arthroscopic Bankart Repair for On-Track Hill-Sachs Lesions With <20% Glenoid Bone Loss. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671261430742

[5] No difference in outcomes for posterior shoulder instability surgery in patients with a normal vs. pathological radiologist reported magnetic resonance arthrogram study. JSES Reviews, Reports, and Techniques. 2026. DOI: 10.1016/j.xrrt.2026.100675

[6] Open Capsular Shift with Achilles Allograft Augmentation for Multidirectional Shoulder Instability: Long-Term Outcomes and Implications for Patients with Ehlers-Danlos Syndrome. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2026.05.024

[7] A comparison of reverse shoulder arthroplasty and glenohumeral arthrodesis for end-stage shoulder instability. JSES International. 2026. DOI: 10.1016/j.jseint.2025.101429

[8] Traumatic posterior shoulder dislocation with associated acromion fracture: a report of 2 cases. JSES Reviews, Reports, and Techniques. 2026. DOI: 10.1016/j.xrrt.2025.09.006

[9] Clinical outcomes following arthroscopic repair of posterior humeral avulsion of glenohumeral ligament in recurrent anterior shoulder dislocations. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2025.04.020

[10] Modified Kouvalchouk technique for recurrent posterior instability of the shoulder. JSES International. 2026. DOI: 10.1016/j.jseint.2026.101681

[11] Appraisal of the Presence of Spin in Abstracts of Systematic Reviews and Meta-analyses Regarding Free Bone Block Procedures for Glenohumeral Instability. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465251338079

[12] Bilateral posterior shoulder dislocations with reverse Hill-Sachs lesions: a report of two cases and a literature review. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09537-y

[13] Management of a first time anterior shoulder dislocation: the decision-making process of a surgeon. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2025.07.018

[14] Combining Instability Severity Index Score and Hill‐Sachs Interval‐to‐Glenoid Track Ratio Predicts Recurrent Instability After Arthroscopic Bankart Repair in Patients With <20% Glenoid Bone Loss. Arthroscopy. 2026. DOI: 10.1002/arj.70009

[15] Return to play and recurrent instability rates in open versus arthroscopic anterior shoulder stabilisation in the contact and collision athlete: A systematic review. Knee Surgery, Sports Traumatology, Arthroscopy. 2026. DOI: 10.1002/ksa.70263

[16] Age, labral lesion type, and lesion location are key risk factors for recurrence following arthroscopic labrum repair in patients with anterior shoulder instability: a minimum 10-year follow-up study. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2025.03.034

[17] Labral morphology does not compensate for reduced bony glenoid concavity in stable shoulders. JSES International. 2026. DOI: 10.1016/j.jseint.2025.101422

[18] A retrospective analysis of the promoting effect of kinesio taping on the rehabilitation of military personnel with recurrent shoulder dislocation caused by training injury. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09753-6

[19] Arthroscopic Distal Tibial Allograft Reconstruction With Suture Button Fixation and Capsulolabral Repair for Traumatic Anterior Shoulder Instability Yields High Rates of Graft Union and Improves Clinical Outcomes at 2 Years. Arthroscopy. 2026. DOI: 10.1002/arj.70008

[20] Arthroscopic bone block using an autologous iliac crest graft and concomitant remplissage for severe bipolar bone loss in a young patient with anterior shoulder instability: a case report. JSES Reviews, Reports, and Techniques. 2026. DOI: 10.1016/j.xrrt.2025.100606

[21] In Vivo 3‐Dimensional Glenohumeral Joint Geometry Based Upon Magnetic Resonance Imaging and Computed Tomography Analysis Shows Deeper, Thicker, and Taller Glenoid Labrum Morphology at 12 O’Clock Position in Healthy Young Adults. Arthroscopy. 2026. DOI: 10.1002/arj.70221

[22] Development and validation of a risk prediction model for rotator cuff tears following acute anterior shoulder dislocation. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09550-1

[24] Recurrent inferior shoulder subluxation secondary to incidental traumatic plexitis following arthroscopic rotator cuff repair. JSES Reviews, Reports, and Techniques. 2026. DOI: 10.1016/j.xrrt.2026.100754

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Using Creative Commons Public Licenses

Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees


Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.


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