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Objectives and questions: Clinical registries are fundamental for evaluating outcomes and advancing evidence-based medicine. In 2019, we established a local Shoulder Instability Registry (SIR) to systematically assess the safety, functionality, quality of life, and patient satisfaction following surgical management of shoulder instability (SI). The aim of this study is to provide a comprehensive description of the data collected in our local SIR, highlighting the scope, methodology, and key clinical variables recorded.

Material and methods: The registry includes all patients treated surgically for SI. Data collection includes medical history and surgical techniques. Clinical assessments include ROM, instability-specific tests, hyperlaxity signs, Constant Score, Subjective Shoulder Value, and shoulder instability-specific measures such as Rowe Score and the Western Ontario Shoulder Instability Index. Radiological evaluations included initial and follow-up imaging via X-rays and CT to assess bony lesions and SI-related arthropathy, as well as MRI for soft tissue injuries. Data are documented preoperatively, at 6 months and at 24 months postoperatively.

Results: Since 2019, 654 shoulders have been registered (mean age 31 years, 82% male, mean BMI 26). 70% of Admissions were due to Accidents, 30% due to Illness. 85% of cases were treated arthroscopically, and 15% were treated openly. Baseline clinical scores showed a mean Constant Score of 77 points, mean Subjective Shoulder Value of 49%, mean Rowe Score of 46 points, and mean Western Ontario Shoulder Instability Index of 53. Based on Gerber’s classification, 68% of cases were type B2, 29% B3, 2% B5, and fewer than 2% were classified as B4 or B1. 85% of cases suffered from anterior instability, while only 13% experienced posterior instability, the remaining 2% showed multidirectional instability. When it comes to osteochondral lesions, 20% showed none, 31% showed a glenoid defect, 54% showed a Hill-Sachs lesion and 13% showed a cartilage defect. Dislocations presented as primary events in 24% of cases, while 76% were recurrent. Surgical interventions included 465 (70%) Bankart repairs and 108 (16%) Remplissage procedures for soft tissue stabilization. Bony reconstructions included 52 fragment fixations (8%), 41 coracoid transfers (6%), and 87 iliac crest bone grafts (13%).

Discussion and conclusions: The initial analyses of the SIR provide critical insights into the epidemiology, etiology, and clinical patterns of shoulder instability, as well as baseline impairments and treatment pathways. The registry serves as a valuable platform for scientific research, quality assurance, and clinical decision-making, enabling the integration of the latest evidence into shoulder orthopedic patient care.