Medial Anterior-inferior Capsular Shift in Multidirectional Shoulder Instability

Chung, Soo Tai; Park, Jai Hyung; Kim, Hyoung Soo; Yoo, Jeong Hyun; Kim, Joo Hak; Ji, Jeong Min; Jo, Hwan Hee

Abstract

Purpose: The purpose of this study was to prove the effectiveness of the open medial (glenoid-based) anteriorinferior capsular shift in patients with multidirectional shoulder instability.
Materials and Methods
We reviewed 19 patients treated by medial anterior-inferior capsular shift for multidirectional shoulder instability from March, 1998 to December, 2003. 15 patients of them have experienced recurrent dislocation. 8 patients(42%) showed bilateral laxity and 11 patients(58%) generalized ligamentous laxity, and 2 patients(10.5%) voluntary subluxation. An average follow-up was 24 months (range : 9~32 months).
Results
Pain improved in 18 patients of all. There was an average loss of 10 degree of external rotation, but no limitation of activity of daily living. There was no redislocation and subluxation, but two patients had some apprehension in sports activity. With Rowe score, the result was excellent or good in all patients. There were hematoma and local skin problem in 1 patient, but all had healed up.
Conclusion
Medial anterior-inferior capsular shift in multidirectional shoulder instability provided satisfactory results in pain relief, patient's satisfactions and stability of glenohumeral joint. Though some of them have anterior gleniod deformities and large Hill-Sachs lesions, we could get good stabilities.