Posterior and multidirectional instability of the shoulder: challenges associated with diagnosis and management.

The diagnosis and treatment of posterior and multidirectional instability of the shoulder remain challenging because of complexities in the classification and etiology of the condition and the physical examination of a patient with suspected posterior and multidirectional instability. With an improved understanding of pertinent clinical symptoms and physical examination findings, a successful strategy for nonsurgical and surgical management can be developed. It is essential to understand the biomechanics of repair procedures, relevant pathoanatomy, and techniques of surgical management to optimize surgical success. Arthroscopic techniques have allowed improved diagnosis and treatment of this condition.