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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 20, Issue 12, pp 2579–2584 | Cite as

An arthroscopic pleated capsular shift for recurrent anterior dislocation of the shoulder

  • Dong-Wook Kim
  • Chong-Kwan Kim
  • Sung-Weon JungEmail author
Shoulder

Abstract

Purpose

This study examined the clinical results of an arthroscopic simple pleated capsular shift to treat severe recurrent anterior dislocation of the shoulder.

Methods

Twenty-four patients with anterior labroligamentous periosteal sleeve avulsion or advanced lesions who underwent an arthroscopic simple pleated capsular shift were included in this study. To create an arthroscopic simple pleated capsular shift, redundant capsules, including glenohumeral ligaments, were brought at least 1 cm lateral and 1 cm inferior and shifted to the prepared glenoid. Four sutures were made at the 5, 4, 3, and 1–2 o’clock positions with four anchors. Clinical results were evaluated using a visual analog scale (VAS), ROWE scores, active motion, and return to activity. Statistical analyses were carried out using paired t tests.

Results

Three out of 24 patients had complaints. Two patients with recurrent instability underwent a repeat surgery, while the other patient complained of a stiff shoulder. There was a significant improvement in the VAS and ROWE scores post-operatively versus pre-operatively (p < 0.001, p < 0.001, respectively), but no significant differences in active motion except for external rotation, which decreased post-operatively (p = 0.02).

Conclusions

In patients with severe recurrent anterior dislocation, simple pleated capsular shift provided a reliable result. Four capsular shift sutures, 1 cm lateral and 1 cm inferior from the glenoid, were sufficient to reduce shoulder joint volume and restore stability. The arthroscopic capsular shift could be an alternative method in the case of no available labral lesion for repair.

Level of evidence

Case series, Therapeutic, Level IV.

Keywords

Recurrent dislocation Capsular shift Volume Shoulder 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

IRB

This study was approved by the IRB committee of Samsung Medical Center.

References

  1. 1.
    Bahk MS, Karzel RP, Snyder SJ (2010) Arthroscopic posterior stabilization and anterior capsular plication for recurrent posterior glenohumeral instability. Arthroscopy 26:1172–1180PubMedCrossRefGoogle Scholar
  2. 2.
    Bak K, Spring BJ, Henderson JP (2000) Inferior capsular shift procedure in athletes with multidirectional instability based on isolated capsular and ligamentous redundancy. Am J Sports Med 28:466–471PubMedGoogle Scholar
  3. 3.
    Bohnsack M, Bartels B, Ostermeier S, Rühmann O, Wellmann M, Mansouri F, Hurschler C (2009) Biomechanical stability of an arthroscopic anterior capsular shift and suture anchor repair in anterior shoulder instability: a human cadaveric shoulder model. Knee Surg Sports Traumatol Arthrosc 17:1493–1499PubMedCrossRefGoogle Scholar
  4. 4.
    Boileau P, Villalba M, Héry JY, Balg F, Ahrens P, Neyton L (2006) Risk factors for recurrence of shoulder instability after arthroscopic bankart repair. J Bone Joint Surg Am 88:1755–1763PubMedCrossRefGoogle Scholar
  5. 5.
    Castagna A, Borroni M, Delle Rose G, Markopoulos N, Conti M, Vinci E, Garofalo R (2009) Effects of posterior-inferior capsular plications in range of motion in arthroscopic anterior bankart repair: a prospective randomized clinical study. Knee Surg Sports Traumatol Arthrosc 17:188–194PubMedCrossRefGoogle Scholar
  6. 6.
    Chiang ER, Wang JP, Wang ST, Ma HL, Liu CL, Chen TH (2010) Arthroscopic posteroinferior capsular plication and rotator interval closure after bankart repair in patients with traumatic anterior glenohumeral instability-a minimum follow-up 5 years. Injury 41:1075–1078PubMedCrossRefGoogle Scholar
  7. 7.
    Cohen SB, Wiley W, Goradia VK, Pearson S, Miller MD (2005) Anterior capsulorrhaphy: an in vitro comparison of volume reduction—arthroscopic plication versus open capsular shift. Arthroscopy 21:659–664PubMedCrossRefGoogle Scholar
  8. 8.
    Cooper RA, Brems JJ (1992) The inferior capsular-shift procedure for multidirectional instability of the shoulder. J Bone Joint Surg Am 74:1516–1521PubMedGoogle Scholar
  9. 9.
    Favorito PJ, Langenderfer MA, Colosimo AJ, Heidt RS Jr, Carlonas RL (2002) Arthroscopic laser-assisted capsular shift in the treatment of patients with multidirectional shoulder instability. Am J Sports Med 30:322–328PubMedGoogle Scholar
  10. 10.
    Flanigan DC, Forsythe T, Orwin J, Kaplan L (2006) Volume analysis of arthroscopic capsular shift. Arthroscopy 22:528–533PubMedCrossRefGoogle Scholar
  11. 11.
    Gartsman GM, Roddey TS, Hammerman SM (2000) Arthroscopic treatment of anterior-inferior glenohumeral instability. Two to five-year follow-up. J Bone Joint Surg Am 74:53–66Google Scholar
  12. 12.
    Hovelius L, Körner L, Lundberg B, Akermark C, Herberts P, Wredmark T, Berq E (1983) The coracoid transfer for recurrent dislocation of the shoulder. Technical aspects of the Bristow-Latarjet procedure. J Bone Joint Surg Am 65:926–934PubMedGoogle Scholar
  13. 13.
    Karas SG, Creighton RA, DeMorat GJ (2004) Glenohumeral volume reduction in arthroscopic shoulder reconstruction: a cadaveric analysis of suture plication and thermal capsulorrhaphy. Arthroscopy 20:179–184PubMedCrossRefGoogle Scholar
  14. 14.
    Kim SH, Ha KI, Cho YB, Ryu BD, Oh I (2003) Arthroscopic anterior stabilization of the shoulder: two to six-year follow-up. J Bone Joint Surg Am 85:1511–1518PubMedCrossRefGoogle Scholar
  15. 15.
    McIntyre LF, Caspari RB, Savoie FH III (1997) The arthroscopic treatment of multidirectional shoulder instability: two-year results of a multiple suture technique. Arthroscopy 13:418–425PubMedCrossRefGoogle Scholar
  16. 16.
    Miller MD, Larsen KM, Luke T, Leis HT, Plancher KD (2003) Anterior capsular shift volume reduction: an in vitro comparison of 3 techniques. J Should Elbow Surg 12:350–354CrossRefGoogle Scholar
  17. 17.
    Ozbaydar M, Elhassan B, Diller D, Massimini D, Higgins LD, Warner JJ (2008) Results of arthroscopic capsulolabral repair: bankart lesion versus anterior labroligamentous periosteal sleeve avulsion lesion. Arthroscopy 24:1277–1283PubMedCrossRefGoogle Scholar
  18. 18.
    Patzer T, Habermeyer P, Hurschler C, Bobrowitsch E, Paletta JR, Fuchs-Winkelmann S, Schofer MD (2011) Increased glenohumeral translation and biceps load after SLAP lesions with potential influence on glenohumeral chondral lesions: a biomechanical study on human cadavers. Knee Surg Sports Traumatol Arthrosc 19:1780–1787PubMedCrossRefGoogle Scholar
  19. 19.
    Price MR, Tillett ED, Acland RD, Nettleton GS (2004) Determining the relationship of the axillary nerve to the shoulder joint capsule from an arthroscopic perspective. J Bone Joint Surg Am 86:2135–2142PubMedGoogle Scholar
  20. 20.
    Rowe CR, Patel D, Southmayd WW (1978) The Bankart procedure: a long-term end-result study. J Bone Joint Surg Am 60:1–16PubMedGoogle Scholar
  21. 21.
    Sekiya JK, Willobee JA, Miller MD, Hickman AJ, Willobee A (2007) Arthroscopic multi-pleated capsular plication compared with open inferior capsular shift for reduction of shoulder volume in a cadaveric model. Arthroscopy 11:1145–1151Google Scholar
  22. 22.
    Speer KP, Warren RF, Pagnani M, Warner JJ (1996) An arthroscopic technique for anterior stabilization of the shoulder with a bioabsorbable tack. J Bone Joint Surg Am 78:1801–1807PubMedGoogle Scholar
  23. 23.
    Treaty SH, Savoie SH III, Field TD, Jackson (1999) Arthroscopic treatment of multi directional instability. J Shoulder Elbow Surg 8:345–350CrossRefGoogle Scholar
  24. 24.
    Wiley WB, Goradia VK, Pearson SE (2005) Technical note: arthroscopic capsular plication-shift. Arthroscopy 21:119–121PubMedCrossRefGoogle Scholar
  25. 25.
    Yoo JC, Kim JH, Ahn JH, Lee SH (2007) Arthroscopic perspective of the axillary nerve in relation to the glenoid and arm position: a cadaveric study. Arthroscopy 23:1271–1277PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Department of Orthopedic Surgery, Samsung Changwon HospitalSungkyunkwan University School of MedicineChangwon-siKorea

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