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Orthopaedic surgeons must recognize excessive capsular laxity or large glenohumeral bone defects preoperatively to avoid recurrence of instability. When history, physical examination, and radiographic evaluation are used in conjunction, patients at risk for failure can be identified. The instability severity index score permits precise identification of patients at risk. When treating patients in whom prior surgical intervention has failed, the success of revision procedures correlates to the surgeon's ability to identify the essential pathology and use lesion\u2010specific treatment strategies. Revision procedures remain technically demanding. Keen preoperative and intraoperative judgment is required to avoid additional recurrence of instability after revision procedures, particularly because results deteriorate with each successive operation. Glenoid or humeral defects with greater than 25% bone loss compromise stability provided through the mechanism of concavity compression. These defects must be specifically addressed to avoid recurrence of instability. We prefer anatomic reconstruction techniques combined with capsulolabral repair and, if bone defects are present, anatomic reconstruction with osteochondral allograft.<\/jats:p>","DOI":"10.1016\/j.arthro.2010.11.057","type":"journal-article","created":{"date-parts":[[2011,4,19]],"date-time":"2011-04-19T17:36:05Z","timestamp":1303234565000},"page":"681-694","source":"Crossref","is-referenced-by-count":48,"title":["Failure of Operative Treatment for Glenohumeral Instability: Etiology and Management"],"prefix":"10.1002","volume":"27","author":[{"given":"Apurva S.","family":"Shah","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery and MedSport University of Michigan Ann Arbor Michigan U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S.","family":"Karadsheh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Harvard University Boston Massachusetts 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