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Revision and Complex Problems

Revision instability surgery is the most technically challenging of all open shoulder surgery. Nevertheless, it can also be the most satisfying, if basic principles are observed. When nonanatomic repairs need to be revised, the normal tissue planes are often distorted. This adds significant technical complexity to the procedure and increases the potential risk for complications.

When attempting to salvage failed anterior instability cases, surgeons should be prepared to face challenging scenarios such as distorted anatomic tissue planes, severe scarring, capsular deficiencies from multiple prior surgeries or thermal capsulorrhaphy, bony deficiencies due to erosion or fracture, and subscapularis deficiencies.

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