Forty-two shoulders in 40 patients operated on for anterior instability between 1986 and 1991 were reexamined. The mean follow-up was 47 months. The pathoanatomic findings at surgery were a Bankart lesion in 42 shoulders, a Hill-Sachs lesion in 31 shoulders, and a rounded or defective anterior glenoid rim in 29 shoulders. The surgical technique consisted of an open reinsertion of the anterior capsule-labral complex. Four shoulders had one or more recurrent anterior dislocations, and four shoulders had recurrent anterior subluxations. Three redislocations were caused by severe trauma. The presence and magnitude of a Hill-Sachs lesion did not influence the frequency of recurrence. An osseous defect of the glenoid rim > or = 3 mm was found in three patients, one of whom had redislocation after surgery. In patients with a large Bankart lesion the rate of recurrence was significantly higher.