{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:35:01Z","timestamp":1760920501149,"version":"build-2065373602"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,3,27]],"date-time":"2022-03-27T00:00:00Z","timestamp":1648339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,3,27]],"date-time":"2022-03-27T00:00:00Z","timestamp":1648339200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2022,3,27]],"date-time":"2022-03-27T00:00:00Z","timestamp":1648339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Some young individuals present with shoulder pain without a definite history or complaint of instability. However, careful history taking, physical examination, and high\u2010quality magnetic resonance imaging may reveal evidence of instability of which the patient is unaware. Therefore, a clearer definition of these ambiguous patients is needed. This study aimed to report the characteristics and surgical outcomes of patients with microinstability compared to those of patients with classic recurrent anterior shoulder instability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 2005 to 2018, 35 patients with microinstability (group M) underwent arthroscopic anterior labral repair (AALR) and were compared to 35 sex\u2010 and age\u2010matched patients with classic recurrent anterior shoulder instability (group C) who also underwent AALR. Baseline characteristics, preoperative apprehension test findings, preoperative imaging for the presence of anterior labral and Hill\u2013Sachs lesions, preoperative and postoperative (over 2 years) range of motion (ROM) and functional scores, final complications, and patient satisfaction were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The most common chief complaints in groups M and C were pain (29\/35) and both pain and instability (27\/35), respectively. Only pain during the apprehension test was predominant in group M (M vs. C, 27 vs. 1, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). High incidence of chronic repetitive injuries (26\/35) and acute trauma (28\/35) were observed in groups M and C, respectively. Over half of the patients in group M showed anterior labral lesions on magnetic resonance arthrography (MRA, 18\/35), and 21 patients had Hill\u2013Sachs lesions on MRA\/three\u2010dimensional computed tomography. Finally, 29 patients showed either anterior labral or Hill\u2013Sachs lesions on preoperative imaging. The lesion severity was higher in group C than that in group M. All patients underwent AALR with\/without the remplissage procedure, with no significant differences in final clinical outcomes, complications, and patient satisfaction between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Microinstability is diagnostically challenging and can be diagnosed in young patients with ambiguous shoulder pain during motion, without instability. Pain on anterior apprehension test and subtle labral and\/or Hill\u2013Sachs lesion on imaging study could be diagnostic clues. This condition can be managed with arthroscopic anterior labral repair with or without the remplissage procedure. The possibility of microinstability in young patients with shoulder pain should always be considered, and small anterior labral or Hill\u2013Sachs lesions should be closely monitored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-06941-4","type":"journal-article","created":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T07:02:42Z","timestamp":1648450962000},"page":"3818-3826","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Microinstability characterised by small and easily overlooked anterior labral or Hill\u2013Sachs lesions can be managed with arthroscopic anterior labral repair"],"prefix":"10.1002","volume":"30","author":[{"given":"Su Cheol","family":"Kim","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine 81 Irwon\u2010ro, Gangnam\u2010gu 06351 Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyoung Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine 81 Irwon\u2010ro, Gangnam\u2010gu 06351 Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong Hun","family":"Park","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine 81 Irwon\u2010ro, Gangnam\u2010gu 06351 Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hashem","family":"Bukhary","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine 81 Irwon\u2010ro, Gangnam\u2010gu 06351 Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Il Su","family":"Kim","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine 81 Irwon\u2010ro, Gangnam\u2010gu 06351 Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang Min","family":"Lee","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine 81 Irwon\u2010ro, Gangnam\u2010gu 06351 Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8378-1583","authenticated-orcid":false,"given":"Jae Chul","family":"Yoo","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Samsung Medical Center Sungkyunkwan 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