Posterior shoulder stabilisation is an arthroscopic operation to repair the posterior labrum and tighten the posterior capsule in patients with recurrent posterior shoulder instability or subluxation.
Performed arthroscopically through small incisions. The torn posterior labrum is identified and reattached to the posterior glenoid rim using suture anchors. The posterior capsule is plicated (tightened) with sutures. The operation takes one to one and a half hours.
Surgery is recommended for recurrent posterior instability (subluxation or dislocation) that has not responded to physiotherapy. Posterior instability is less common than anterior instability and often presents with subtle symptoms such as pain, apprehension, or a dead-arm feeling.
Physiotherapy focusing on rotator cuff and scapular stabiliser strengthening, activity modification, and avoidance of provocative positions (forward flexion with internal rotation and adduction).
MRI arthrogram to assess posterior labral pathology. CT to assess glenoid version (retroversion predisposes to posterior instability).
Restoration of posterior stability in approximately 85–90% of patients. Good return to sport rates.
Expected — some restriction is necessary to prevent re-dislocation.
Temporary posterior shoulder tightness.
Approximately 10–15% recurrence rate.
The nerve runs close to the posterior glenoid. Very rare with arthroscopic technique.
Shoulder joint infection.
Excessive posterior capsular plication limiting forward flexion.
General anaesthesia with nerve block.
Sling for four to six weeks. Gentle exercises from one week. Active movement from six weeks. Strengthening from three months. Return to sport at six to nine months.
Reviews at two weeks, six weeks, three months, and six months.
Yes. Posterior instability is less common, more subtle, and often involves subluxation rather than frank dislocation. It is typically provoked by pushing activities (bench press) rather than the abduction-external rotation that causes anterior instability.