The bony anatomy of the glenohumeral joint allows for a wide range of motion of the shoulder but also makes it inherently prone to instability. Shoulder instability is relatively common, especially among athletes who place intense demands on their shoulders and among military personnel.1 Studies have shown that shoulder injuries make up 9.7% of all injuries among college athletes, with 23% of these being instability-related. Furthermore, in the military, the incidence of shoulder dislocations can be as high as 1.7 per 1000 people each year.1,2 Shoulder instability comes in two primary forms: dislocation, a complete loss of joint congruence, and subluxation, a partial dislocation.3,4 These incidents aren't just 1-off events; they range from acute traumas to ongoing stress damage caused by repetitive motion, undermining the shoulder's supporting structures. Shoulder instability can be anterior, posterior, or multidirectional, depending on the direction from which the humeral head disarticulates. Anterior dislocations make up the majority of shoulder instability cases.5 For many athletes, shoulder stabilization surgery is sought as a definitive treatment to return to pre-injury levels of activity.

Careful patient selection is one of the key factors in achieving successful outcomes in treating shoulder instability. While shoulder stabilization surgery has advanced significantly, yielding many excellent outcomes, a persistent challenge remains recurrent instability, which occurs at a rate of 3-%25% following primary stabilization procedures.6, 7, 8 When a shoulder stabilization procedure fails, patients are faced with a cascade of negative outcomes, including increased discomfort, decreased mobility, and a forced hiatus from work and sports activities, cumulatively leading to a decline in their overall quality of life. Athletes, in particular, face a complex set of challenges when they experience failed stabilization procedures. Their journey has often been fraught with an initial destabilizing injury, possibly repeated episodes, significant time away from their sport, and the physical and emotional toll of surgery followed by extensive rehabilitation. Now faced with the prospect of further surgery, additional rehabilitation, and the very real risk of another failure, they also confront the daunting uncertainty of whether they'll be able to return to their sport at all. Effective management of athletes post-failure involves a meticulous examination of the various factors that may have contributed to the failure of the initial procedure. Revision surgery, therefore, must not only rectify these issues but also ensure a stable shoulder that can withstand the demands of their sport. Only by addressing these factors comprehensively can athletes hope to resume their careers and regain their pre-injury performance levels.