CME expires February 29, 2028

Go beyond traditional learning with a 360° perspective on orthopedic topics.

Each ICL360 is a cutting-edge CME course designed to provide a holistic learning experience, featuring curated video content sourced from expert-selected Instructional Course Lectures enhanced with insightful commentary and comprehensive assessment questions. This all-encompassing course goes beyond traditional learning by offering a complete 360° perspective on orthopedic topics. Explore additional resources, including full-text readings from the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), technique videos from Orthopaedic Video Theater (OVT), and links to external literature and PubMed. Elevate your clinical decision-making skills and gain a well-rounded understanding of essential orthopedic concepts with ICL360.

This Instructional Course Lecture (ICL) focuses on the diagnosis, evaluation, and management of posterior labrum tears of the shoulder, which is a condition characterized by pain and instability in the glenohumeral joint. Although posterior labrum tears are less common compared with other shoulder pathology, they represent a considerable challenge in highly active patient populations, particularly athletes and military personnel who are involved in overhead or contact sports. The lecture explores the critical aspects of shoulder anatomy, shoulder biomechanics, and the unique challenges associated with posterior labrum injuries. It highlights the dynamic balance of stabilizers in the glenohumeral joint and the mechanisms leading to labral damage, such as repetitive stress and acute trauma.

The lecture explores contemporary imaging modalities, such as MRI and CT, for accurate diagnosis, and explains the importance of a thorough patient history and physical examination. The role of nonsurgical treatment, including physical therapy and scapular kinematics, is emphasized as a first-line treatment option for certain patients; however, the effectiveness of arthroscopic stabilization with the use of knotless all-suture anchors is highlighted for patients who require surgical treatment. This technique is a minimally invasive and efficient option to restore shoulder stability while preserving surrounding structures.

The lecture also introduces a structured rehabilitation protocol designed to ensure optimal recovery and a safe return to sports or high-demand activities. The phased rehabilitation approach encompasses protection, mobility, strength, and sport-specific training tailored to each patient's needs. This comprehensive framework provides surgeons with evidence-based strategies to improve outcomes and minimize recurrence.

Editor
Edward Walker Gallego, MD, FAAOS 

Learning Objectives

• Identify the anatomy and biomechanics of the glenohumeral joint, focusing on its static and dynamic stabilizers and their roles in shoulder stability.
• Analyze the etiology of, clinical presentation of, and evaluation methods for posterior labrum tears, emphasizing their prevalence in highly active patient populations.
• Interpret findings for posterior labrum injuries on radiographs, CT scans, and MRIs, including associated lesions, such as reverse Bankart and Hill-Sachs lesions.
• Demonstrate proficiency in arthroscopic posterior labrum repair, including portal placement and the use of knotless all-suture anchors.
• Develop patient-specific treatment plans, comparing nonsurgical treatment with surgical stabilization based on clinical indicators and prognostic factors.
• Implement a structured rehabilitation protocol for patients who undergo arthroscopic repair, aligning with the Multicenter Orthopaedic Outcomes Network guidelines for posterior stabilization.
• Evaluate the effectiveness of posterior labrum repair techniques in restoring function, preventing recurrence, and enabling safe return to sports activity or active duty.
• Outline complications and considerations associated with the management of posterior shoulder instability in special patient populations, such as athletes and military personnel.

Earn up to 5 AMA PRA Category 1 CME credits™.