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An algorithm is to divide the patients into primary and revision cases then to further subdivide patients who have glenoid bone loss &lt;20% and\/or an engaging or off\u2010track Hill\u2013Sachs lesion. A bipolar lesion with either of these conditions is an indication for a bone block open Laterjet procedure. In the revision setting, the threshold for Laterjet is lower. Soft\u2010tissue lesions are indications for a Bankart or labral repair. With the proper attention given to concomitant labral, biceps, and rotator cuff pathology, Hill\u2010Sachs lesions less than 1 cm are left alone. However, in situations where lesions are deeper than 1 cm, an arthroscopic remplissage is indicated. An optimal repair aims to create a labral bumper and a bony bed for the soft tissue to heal, whereas inferior quality of soft tissue indicates a segmental labral reconstruction. Reconstructing large capsular rents with torn ligaments with allograft anterior capsular repair is also needed for proper biomechanical restoration.<\/jats:p>","DOI":"10.1016\/j.arthro.2021.02.014","type":"journal-article","created":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T20:18:25Z","timestamp":1619122705000},"page":"1434-1436","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["<i>Editorial Commentary<\/i>\n                    : Anterior Shoulder Instability in Adolescent Athletes: \u201cSlaying the Hydra\u201d Is a Subtle Art"],"prefix":"10.1002","volume":"37","author":[{"given":"Anish G.R.","family":"Potty","sequence":"first","affiliation":[{"name":"South Texas Orthopedic Research Institute (STORI Inc.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugo C.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"South Texas Orthopedic Research Institute (STORI Inc.)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,1]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.12.211"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(03)00684-4"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511411699"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-20-04-242"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2006.12.012"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967118813981"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S074980632100147X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S074980632100147X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2021.02.014","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2021.02.014","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2021.02.014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T08:49:40Z","timestamp":1773564580000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2021.02.014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":6,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1016\/j.arthro.2021.02.014"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2021.02.014","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Editorial Commentary: Anterior Shoulder Instability in Adolescent Athletes: \"Slaying the Hydra\" Is a Subtle Art","name":"articletitle","label":"Article Title"},{"value":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2021.02.014","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"simple-article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 Published by Elsevier on behalf of the Arthroscopy Association of North America","name":"copyright","label":"Copyright"}]}}