REVIEW ARTICLE
Multidirectional Instability: Natural History and Evaluation
Miguel García Navlet1, *, Cristina Victoria Asenjo-Gismero2
Article Information
Identifiers and Pagination:
Year: 2017Volume: 11
Issue: Suppl-6, M5
First Page: 861
Last Page: 874
Publisher ID: TOORTHJ-11-861
DOI: 10.2174/1874325001711010861
Article History:
Received Date: 16/5/2016Revision Received Date: 26/10/2016
Acceptance Date: 28/10/2016
Electronic publication date: 31/08/2017
Collection year: 2017

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background:
Multidirectional instability (MDI) represents a great challenge to the orthopedic surgeon. When treating these patients we must be aware that instability refers to a symptomatic situation, thus multidirectional instability is defined as symptomatic involuntary instability in two or more directions, and should be clearly differentiated from asymptomatic hyperlaxity.
It may be associated with hyperlaxity, either congenital or acquired following repetitive stress, but also may be present without hyperlaxity, which is rare.
Methods:
We searched in the online data bases and reviewed the relevant published literature available.
Results:
Many differences can be seen in the current literature when identifying these patients, unclear definitions and criteria to be included in this patient group are common.
Conclusion:
Understanding the complex shoulder biomechanics as well as being aware of the typical clinical features and the key examination signs, which we review in this article, is of paramount importance in order to identify and classify these patients, allowing the best treatment option to be offered to each patient.