Pittsburgh Instability Tool (PIT) score

Recurrence risk after primary arthroscopic anterior shoulder stabilization, scored for Bankart repair alone and with remplissage. For patients aged 14 to 40 with an on-track Hill-Sachs lesion and glenoid bone loss of 20% or less.

Prognostic factors

Patient age at surgery
Contact sport status

Football, soccer, hockey, rugby, wrestling, basketball and similar.

Glenoid bone loss

Not scored for contact athletes, who take the 7 points above.

Shoulder laxity on examination under anesthesia

Hyperlaxity: external rotation over 85° or grade 2+ load-and-shift in the anterior, posterior and inferior planes.

Distance to dislocation

DTD = glenoid track − Hill-Sachs interval. A DTD below 0 mm is off-track and outside this tool.

Preoperative instability episodes

PIT score by operation

Bankart repair only (ABR) – / 25
Bankart + remplissage (ABR+R) – / 25
0–3Low4–8Moderate9–13High14–25Extreme

Points

Recurrence figures are the proportions of patients in each risk group who had a recurrent dislocation or subjective subluxation in the derivation cohort: 170 patients at one center, reviewed retrospectively, mean follow-up 5.1 years. The score has not been externally validated. Remplissage subtracts 8 points and the score never falls below zero.

Source: Charles S, Marcaccio S, Lin RT, et al. The Pittsburgh Instability Tool Score Predicts Outcomes After Arthroscopic Anterior Shoulder Stabilization in Patients With Subcritical Bone Loss. Arthroscopy 2025;41(10):3857-3868, Figure 3. doi:10.1016/j.arthro.2025.04.023. This page supports clinical judgment and does not replace it.