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多向肩关节不稳定（Multidirectional instability，MDI）相对少见，约占所有肩关节不稳定的2%～10%。Neer对于有症状的多向肩关节不稳的定义是，大于2个方向的不稳定，其中一个方向是下方。在临床中，需要与单向前方不稳定鉴别。手术治疗成功的关键在于：恢复盂唇完整性、缩减关节囊，修复SLAP损伤（如有）。今天介绍一种对于伴有II型SLAP病变的MDI中，使用无节全缝合锚钉（Knotless all-suture anchors）进行关节镜下唇修复（labral repair）和全囊移位技术（pancapsular shift）。下面以图为例介绍。  Arthroscopic view of right shoulder from the standard posterior viewing portal showing a SLAP type II lesion and tear of the anterior labrum. The SLAP complex (SC) can be seen shifted off the superior glenoid (G). (HH, humeral head.) 标准后入路，右肩关节镜可见SLAP II型病变和前方盂唇撕裂。可见SLAP复合体（SC）从上关节盂（G）移位。（HH，肱骨头。）
 With the patient in the beach-chair position, placement of the first anchor at the 5.30-o’clock position through the anteroinferior working portal is visualized via a standard posterior viewing portal during repair of a right anterior labral tear. A 135。trajectory of the drill guide (DG) relative to the glenoid face (G) is visualized in the arthroscopic (A) and external (B) views, which ensures adequate deployment of the anchor in the subchondral bone. (CT, capsular tissue.).沙滩椅位,右肩前方唇撕裂的修复，通过标准的后方入路可以看到第一枚锚钉，通过前下方入路在5.30点钟位置的放置。A、B：导向器与肩胛盂成135度。CT：关节囊组织。
 Arthroscopic (A) and external (B) views of a right shoulder via standard posterior viewing portal during repair of a right anterior labral tear to the glenoid (Gl) with the first repair anchor at the 5:30 o’clock position during the tightening of the repair suture. The amount of capsular shift of capsular tissue (CT) in the labral repair construct determines the reduction of capsular volume. Employing a grasper (Gr) ensures anatomic reduction of the labrumecapsule complex to the anterior glenoid. 置入第一枚锚钉后，将关节囊及盂唇缝合至肩胛盂，进行盂唇修复和关节囊紧缩。
 Arthroscopic (A) and external (B) views of a right shoulder via the anterosuperior portal presenting the placement of the first repair anchor for a repair of the right posterior labrum to the glenoid (G) in a 6:30-o’clock position. On both the arthroscopic (A) and external (B) views, the drill guide (DG) trajectory can be visualized.右肩通过前上入路观察，锚钉用于在6:30点钟位置将右肩后方下方盂唇修复到关节盂（G）。
 Arthroscopic (A) and external (B) views of a right shoulder via standard posterior viewing portal during repair of a SLAP type II lesion at the 1:00 o’clock position during placement of the first anchor with the drill guide (DG). Glenoid (G).通过标准后方入路，在1点钟位置修复SLAP II型病变。
 Arthroscopic (A) and external (B) views view of right shoulder via an anterosuperior viewing portal showing the completed panlabral repair using 9 knotless, all-suture anchors (arrows) (6 visible). Due to the capsular shift resulting in a reduced capsular volume, this is the broadest overview to be ob- tained at this point. (G, glenoid.)右肩，通过前上入路观察，显示使用9个无节全缝合锚钉箭头）（其中6个可见）完成的盂唇修复。
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