Is it the standard of care? Shoulder surgery has grown much in the last decade. Even in the presence of engaging Hill Sach's , soft tissue reconstruction, bony procedures, arthroscopy has a major role.
Identifying the precise pathology whether it is ALPSA, HAGL, RHAGL. Bony bankart's, engaging Hill sach's, pathology specific management is the Standard of care. Puttiplatt's surgery is definitely history(arthritis after stabilisation as the tight anterior structure predispose to posterior wear of the glenoid., the role of Bristow's procedure is controversial. Latarjets modified both arthroscopic and open is advised to increase the arc of glenoid extrarticularly in engaging Hillsach's and has the best results to date.
Timing of surgery is more controversial. Do we intervene for the young first time dislocator with a bankarts or immobilise first in external rotation. multiple recurances can give rise to plastic deformation of both the anterior and posterior capsule leading to various techniques to tighten in both directions and centering the head.on nthe glenoid.
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