This patient has multidirectional instability and atraumatic instability. She needs aggressive rehabilitation for at least 3 to 6 months before ever considering surgical intervention. Rotator cuff strengthening is the mainstay of physical therapy efforts. Thermal capsulorrhaphy has recently been shown to have a high risk of recurrent instability in this population.2 These patients rarely have a Bankart tear. Ultrasonography and other imaging modalities play a very limited role in patients with multidirectional instability.
- Rotator cuff strengthening exercises.
2. Sperling JW, Anderson K, McCarty EC, Warren RF. Complications of thermal capsulorrhaphy. Instr Course Lect 2001;50:37-41.
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