Paksoy Alp, Akgün Doruk, Lappen Sebastian, Moroder Philipp
Charité University Hospital, Center for Musculoskeletal Surgery, Augustenburger Platz 1, Berlin, Germany.
Schulthess Klinik, Lengghalde 2, Zurich, Switzerland.
EFORT Open Rev. 2024 May 10;9(5):403-412. doi: 10.1530/EOR-24-0025.
Posterior shoulder instability (PSI) is less common than anterior shoulder instability, accounting for 2-12% of total shoulder instability cases. However, a much higher frequency of PSI has been recently indicated, suggesting that PSI accounts for up to 24% of all young and active patients who are surgically treated for shoulder instability. This differentiation might be explained due to the frequent misinterpretation of vague symptoms, as PSI does not necessarily present as a recurrent posterior instability event, but often also as mere shoulder pain during exertion, limited range of motion, or even as yet asymptomatic concomitant finding. In order to optimize current treatment, it is crucial to identify the various clinical presentations and often unspecific symptoms of PSI, ascertain the causal instability mechanism, and accurately diagnose the subgroup of PSI. This review should guide the reader to correctly identify PSI, providing diagnostic criteria and treatment strategies.
肩后不稳（PSI）不如肩前不稳常见，占所有肩部不稳病例的2% - 12%。然而，最近有迹象表明PSI的发生率要高得多，这表明在所有因肩部不稳接受手术治疗的年轻活跃患者中，PSI占比高达24%。这种差异可能是由于对模糊症状的频繁误判，因为PSI不一定表现为复发性后向不稳事件，还常常仅表现为用力时的肩部疼痛、活动范围受限，甚至是无症状的伴随发现。为了优化当前的治疗方法，识别PSI的各种临床表现和通常不具特异性的症状、确定不稳定的因果机制并准确诊断PSI亚组至关重要。本综述应指导读者正确识别PSI，提供诊断标准和治疗策略。
