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PICO question In dogs with medial shoulder instability, what treatment option results in the best patient outcomes medical vs. surgical management?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed 10 papers were critically reviewed. Whilst one study was prospective in nature, it was performed in research dogs that were then euthanised to evaluate outcome of various surgical procedures. Of the remaining nine papers reviewed, six were retrospective studies, two were case reports, and one was a combination of a cadaveric project with case report Strength of evidence Weak Outcomes reported Surgical and medical treatment of medial shoulder instability can be successful. There is no strong evidence to support one surgical treatment over another Conclusion Dogs diagnosed with medial shoulder instability may be treated successfully with either medical or surgical management   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

There is no superior treatment method for medial shoulder instability in dogs