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General Orthopaedics

FUNCTIONAL OUTCOMES FOLLOWING ARTHROSCOPIC SHOULDER STABILIZATION AND CAPSULAR PLICATION IN PATIENTS WITH ATRAUMATIC SHOULDER INSTABILITY

Canadian Orthopaedic Association (COA)



Abstract

Purpose

An open superior capsular shift is a well-established technique for the management of patients with multidirectional shoulder laxity and the absence of a Bankart lesion. Few studies have reported on functional and quality of life outcomes using arthroscopic technique for shoulder stabilization using superior capsular shift in patients with no Bankart lesion. The purpose of this study was to assess the functional and quality of life outcome scores following shoulder stabilization with a selective arthroscopic superior capsular shift with suture anchors, for treatment of multidirectional laxity and the absence of a Bankart lesion.

Method

Case Series Level 4 Evidence

Thirty-six (36) patients with a mean age of 30.8 years, with a diagnosis of recurrent anterior atraumatic shoulder instability, and no Bankart lesion, were identified in a single surgeons practice. These patients underwent an arthroscopic shoulder stabilization with an anterior inferior to superior capsular shift. The labrum was arthroscopically released from the anterior/inferior glenoid and was shifted superiorly in conjunction with a capsular plication. A retrospective analysis was performed on prospectively collected outcome scores of patients who had with a minimum of 1 year of follow-up. The ASES and WOSI scores were administered pre-operatively and at 6 and 12 month follow-up. The presence of a positive post-operative apprehension sign was also recorded on follow-up.

Results

After an arthroscopic capsular shift, the ASES and WOSI scores improved significantly from 57, 28 to 78, 68 respectively (P<0.001). Few patients had a positive apprehension sign at 1 year follow-up.

Conclusion

An arthroscopic capsular shift is a reliable procedure that resulted in satisfactory outcomes in patients with shoulder instability and the absence of a Bankart lesion.