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Multidirectional Instability: Open Surgical Revision in Patients With Soft-Tissue Deficiency or Collagen Disorders
Multidirectional instability (MDI) is defined as symptomatic glenohumeral instability in the anterior, posterior, and inferior directions. It consists of anteroinferior dislocation with posterior subluxation, posteroinferior dislocation with anterior subluxation, or dislocation in all three directions. In normal shoulders, passive manipulation can result in a wide range of translation because laxity varies widely. In patients with MDI, symptoms result from excessive translation of the humeral head on the glenoid with use of the arm. The definition of MDI does not refer to the amount of native laxity in the shoulder but to the occurrence of symptoms when subluxation or dislocation occurs in multiple directions.