 How important is patient positioning during arthroscopic shoulder repair? A new report suggests that the use of lateral decubitus vs. beach chair positioning does not affect the outcome of arthroscopic posterior labral repair. The findings are published in the American Journal of Sports Medicine. Shoulder dislocation or repetitive microtrauma to the shoulder can tear the posterior labrum, resulting in posterior shoulder instability. Although posterior instability is not as common as anterior instability, it can cause persistent pain and recurrent problems over time. Arthroscopic surgery is frequently used to repair the posterior labrum. Some physicians prefer to place patients in the lateral decubitus position for the surgery, while others prefer the beach chair position. Each position has its own advantages, but it remains unclear whether one provides superior patient outcomes. To find out, researchers recently reviewed the records for 126 patients who underwent surgery for posterior labrum tears at a single multi-center institution between 2015 and 2019. 69 of the patients were placed in lateral decubitus position during surgery, while 57 were placed in the beach chair position. Clinical and patient-reported outcomes were compared between the two positions. The rates of postoperative dislocations, subjective instability, re-operations, revisions and complications didn't differ between positions. Among the subset of patients with patient-reported outcome data, there were no differences in return to sport or in three different indices of shoulder function and pain. The overall recurrence rate was 8.7%, indicating good outcomes for both positions. Older age was identified as a weak but significant risk factor for subjective instability among all patients. Notably, this retrospective study had several limitations. The patients were not randomized and the surgeons had considerable experience with the procedure. Glenoid and humeral bone loss was not evaluated. In addition, the sample sizes may have been too small to reveal other risk factors or differences in instability between the groups. 28% of the patients were lost to follow-up and only 55% of the originally identified patients had patient-reported outcome data. Improvements in patient-reported outcomes were not measured. Furthermore, some patients may not have returned to sport due to choice rather than dysfunction, so the reported rates may be lower than those in similar studies. Finally, anchor placement wasn't assessed. Despite these limitations, the studies suggest that both the lateral decubitus and beach chair positions are equally good choices for arthroscopic posterior labral repair.