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Experts were assigned to 1 of 6 working groups defined by specific subtopics within posterior shoulder instability. Consensus was defined as achieving 80% to 89% agreement, whereas strong consensus was defined as 90% to 99% agreement, and unanimous consensus was indicated by 100% agreement with a proposed statement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Unanimous agreement was reached on the indications for nonoperative management and labral repair, which include whether patients had primary or recurrent instability, with symptoms\/functional limitations, and whether there was other underlying pathology, or patient\u2019s preference to avoid or delay surgery. In addition, there was unanimous agreement that recurrence rates can be diminished by attention to detail, appropriate indication and assessment of risk factors, recognition of abnormalities in glenohumeral morphology, careful capsulolabral debridement and reattachment, small anchors with inferior placement and multiple fixation points that create a bumper with the labrum, treatment of concomitant pathologies, and a well\u2010defined rehabilitation protocol with strict postoperative immobilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study group achieved strong or unanimous consensus on 63% of statements related to the diagnosis, nonoperative treatment, and labrum repair for posterior shoulder instability. The statements that achieved unanimous consensus were the relative indications for nonoperative management, and the relative indications for labral repair, as well as the steps to minimize complications for labral repair. There was no consensus on whether an arthrogram is needed when performing advanced imaging, the role of corticosteroids\/orthobiologics in nonoperative management, whether a posteroinferior portal is required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level V, expert opinion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2024.04.035","type":"journal-article","created":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T01:27:48Z","timestamp":1715390868000},"page":"166","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":19,"title":["Posterior Shoulder Instability, Part I\u2014Diagnosis, Nonoperative Management, and Labral Repair for Posterior Shoulder Instability\u2014An International Expert Delphi Consensus Statement"],"prefix":"10.1002","volume":"41","author":[{"given":"Eoghan T.","family":"Hurley","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Durham North Carolina U.S.A."},{"name":"Department of Orthopedic Surgery NYU Langone Health New York U.S.A."},{"name":"Midwest Orthopaedics at RUSH Rush University Medical Center Chicago Illinois U.S.A."},{"name":"Department of Orthopaedic Surgery Rothman Institute\u2010Thomas Jefferson University Philadelphia Pennsylvania U.S.A."},{"name":"Department of Orthopedics and Sports Medicine University of Washington Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary S.","family":"Aman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Durham North Carolina U.S.A."},{"name":"Department of Orthopedic Surgery NYU Langone Health New York U.S.A."},{"name":"Midwest Orthopaedics at RUSH Rush University Medical Center Chicago Illinois U.S.A."},{"name":"Department of Orthopaedic Surgery Rothman Institute\u2010Thomas Jefferson University Philadelphia Pennsylvania U.S.A."},{"name":"Department of Orthopedics and Sports Medicine University of Washington Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom R.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Durham North Carolina U.S.A."},{"name":"Department of Orthopedic Surgery NYU Langone Health New York U.S.A."},{"name":"Midwest Orthopaedics at RUSH Rush University Medical Center Chicago Illinois U.S.A."},{"name":"Department of Orthopaedic Surgery Rothman Institute\u2010Thomas Jefferson University Philadelphia Pennsylvania U.S.A."},{"name":"Department of Orthopedics and Sports Medicine University of Washington Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay M.","family":"Levin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Durham North Carolina U.S.A."},{"name":"Department of Orthopedic Surgery NYU Langone Health New York U.S.A."},{"name":"Midwest Orthopaedics at RUSH Rush University Medical Center Chicago Illinois U.S.A."},{"name":"Department of Orthopaedic Surgery Rothman Institute\u2010Thomas Jefferson University Philadelphia Pennsylvania U.S.A."},{"name":"Department of Orthopedics and Sports Medicine University of Washington Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laith M.","family":"Jazrawi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Durham North Carolina U.S.A."},{"name":"Department of Orthopedic Surgery NYU Langone Health New York U.S.A."},{"name":"Midwest Orthopaedics at RUSH Rush University Medical Center Chicago Illinois U.S.A."},{"name":"Department of Orthopaedic Surgery Rothman Institute\u2010Thomas Jefferson University Philadelphia Pennsylvania U.S.A."},{"name":"Department of Orthopedics and Sports Medicine University of Washington Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant E.","family":"Garrigues","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Durham North Carolina U.S.A."},{"name":"Department of Orthopedic Surgery NYU Langone Health New York U.S.A."},{"name":"Midwest Orthopaedics at RUSH Rush University Medical Center Chicago Illinois U.S.A."},{"name":"Department of Orthopaedic Surgery Rothman Institute\u2010Thomas Jefferson University Philadelphia Pennsylvania U.S.A."},{"name":"Department of Orthopedics and Sports Medicine University of Washington Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surena","family":"Namdari","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Durham North Carolina U.S.A."},{"name":"Department of Orthopedic Surgery NYU Langone Health 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U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher S.","family":"Klifto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Durham North Carolina U.S.A."},{"name":"Department of Orthopedic Surgery NYU Langone Health New York U.S.A."},{"name":"Midwest Orthopaedics at RUSH Rush University Medical Center Chicago Illinois U.S.A."},{"name":"Department of Orthopaedic Surgery Rothman Institute\u2010Thomas Jefferson University Philadelphia Pennsylvania U.S.A."},{"name":"Department of Orthopedics and Sports Medicine University of Washington Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oke","family":"Anakwenze","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Durham North Carolina U.S.A."},{"name":"Department of Orthopedic Surgery NYU Langone Health New York U.S.A."},{"name":"Midwest Orthopaedics at RUSH Rush University 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