How does the 'On-track / Off-track' concept assist surgical decision-making in shoulder instability?

Doctor’s answer

The concept evaluates the dynamic interaction between glenoid bone loss and humeral Hill-Sachs lesions. An 'Off-track' lesion engages the anterior glenoid rim during abduction and external rotation, increasing instability risk. When substantial glenoid bone loss is present (typically >15-20%), bony augmentation such as the Latarjet procedure is often considered; for smaller glenoid defects with Off-track engagement, arthroscopic Bankart repair combined with Remplissage or other tailored stabilization may be evaluated.

This content is for education. Diagnosis, treatment, and rehabilitation require an individual assessment by a sports medicine specialist.