Sixty-three patients with shoulder instability were randomized to receive either the Instability Severity Index Score (ISIS)-based treatment algorithm (n=33) or a conventional treatment algorithm (CTA; n=30). The primary outcome of interest was the Western Ontario Stability Index (WOSI). Secondary outcomes included the American Shoulder and Elbow Surgeons (ASES) score, apprehension rates, and recurrence rates. Outcomes were assessed up to 24 months post-randomization. Overall, the results of the study revealed no statistically significant differences in the WOSI scores (ISIS 84.3±21 vs. CTA 83.4±14.5, p=0.89), ASES scores (ISIS 90±22.4 vs. CTA 91.2±11.2, p=0.87), or apprehension rates (10% in each group, p=1.00). There were no re-dislocations in either group at 24 months, with one revision surgery in the ISIS group and two in the CTA group. These findings suggest that both treatment algorithms provide similar outcomes for patients with shoulder instability.