Background: Shoulder instability, particularly anterior instability, remains a significant clinical and socioeconomic burden, especially in young, active populations. Recent advancements have refined our understanding of critical and subcritical bone loss, bipolar lesions, and dynamic stabilization concepts. Methods: This review synthesizes current evidence by analyzing recent clinical studies, biomechanical research, and technological developments related to the management of anterior shoulder instability.Results: While traditional soft-tissue procedures such as the Bankart repair maintain a role in select low-risk patients, emerging data support earlier consideration of bony augmentation or dynamic stabilization in high-risk cohorts. Moreover, technologies such as dynamic anterior stabilization, arthroscopic Latarjet procedures, suture-button fixation, and biologic augmentation strategies are redefining treatment algorithms. Conclusions: Recent advances have reshaped the approach to shoulder instability, emphasizing individualized strategies based on bone loss, patient risk profile, and dynamic stabilizing techniques. An evidence-based framework is essential for optimizing clinical outcomes.Level of evidence: V.
Kim et al. (Tue,) studied this question.