Anteromedial capsular redundancy and labral deficiency in shoulder instability

Am J Sports Med. 2003 Mar-Apr;31(2):247-52. doi: 10.1177/03635465030310021501.

Abstract

Background: Redundancy of the anteromedial capsule of the shoulder may persist despite proper tensioning of the capsule and repair of a Bankart lesion during an anteroinferior capsular shift procedure.

Hypothesis: A barrel-stitch suture technique incorporated into a capsular shift procedure is effective in achieving satisfactory shoulder stability.

Study design: Uncontrolled retrospective review.

Methods: A barrel-stitch technique was used for patients identified as having anteromedial capsular redundancy during a capsular shift procedure for anteroinferior instability.

Results: The incidence of anteromedial capsular redundancy and labral deficiency was 49% (38 of 78). Patients with anteromedial capsular redundancy had a significantly greater number of dislocations before surgery (16.1 +/- 21.3 versus 7.4 +/- 7.4) and a greater duration of symptoms (79.8 +/- 84.2 versus 31.6 +/- 32.2 months). The mean postoperative Rowe score of patients with anteromedial capsular redundancy was 88.7 +/- 14.8, with 92% having excellent or good results, compared with 88.9 +/- 14.8 in the remaining patients and 93% excellent or good results.

Conclusions: Anteromedial capsular redundancy is associated with longer preoperative duration of symptoms and more dislocations, but effective treatment can be achieved with a capsular shift procedure augmented with medial capsular imbrication with a barrel stitch.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Joint Capsule / physiopathology
  • Joint Capsule / surgery*
  • Joint Instability / rehabilitation
  • Joint Instability / surgery*
  • Male
  • Middle Aged
  • Orthopedic Procedures / methods*
  • Physical Therapy Modalities
  • Retrospective Studies
  • Shoulder Joint / physiopathology
  • Shoulder Joint / surgery*
  • Suture Techniques*
  • Treatment Outcome