J Korean Orthop Assoc.  2009 Feb;44(1):29-36. 10.4055/jkoa.2009.44.1.29.

Comparison of Open and Arthroscopic Inferior Capsular Shifts for Multidirectional Instability of the Shoulder

• Yi JW
• Cho NS
• Son ES
• Rhee YG

• KMID: 2186375
• DOI: http://doi.org/10.4055/jkoa.2009.44.1.29

Abstract

PURPOSE: To compare outcomes of open and arthroscopic inferior capsular shifts in multidirectional instability of the shoulder and to evaluate the factors affecting the outcomes.
MATERIALS AND METHODS
We measured outcomes in 81 patients (84 shoulders) receiving open or arthroscopic inferior capsular shifts because of multidirectional instability of the shoulder from February, 1994, to April, 2006. There were 76 males and 8 females. Their mean age was 22 years at the time of surgery. The visual analogue scale (VAS) for pain, shoulder range of motion (ROM), and Rowe scores were evaluated preoperatively and postoperatively.
RESULTS
In open surgery, the VAS for pain was 5.3 preoperatively and 2.1 postoperatively. VAS for instability changed from 4.6 to 1.7, and the average postoperative Rowe score was 83.7. Forward flexion was 173.7degrees preoperatively and 166.1degrees postoperatively. External rotation on the side changed from 75.5degrees to 62.7degrees. In arthroscopic surgery, the VAS for pain was 4.6 preoperatively and 1.2 postoperatively. VAS for instability changed from 5.9 to 1.2, and the average postoperative Rowe score was 87.4. Forward flexion was 169.5degrees preoperatively and 171.2degrees postoperatively. External rotation changed from 70.8degrees to 61.4degrees.
CONCLUSION
Arthroscopic surgery was more effective in decreasing pain and conserving forward flexion of the shoulder than open surgery. Postoperative instability appeared to be related with generalized or bilateral shoulder joint laxity. Pain during motion after the operation was more significant during a voluntary subluxator. Low clinical scores were related with the operation on the dominant side or postoperative instability.

Keyword

Shoulder; Multidirectional instability; Inferior capsular shift

MeSH Terms

Arthroscopy
Female
Humans
Male
Range of Motion, Articular
Shoulder
Shoulder Joint
Shoulder Pain

Figure

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  Fig. 1 Suture were placed through drill holes and passed through the advanced capsule.

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  Fig. 2 (A) This photograph shows the patulous joint capsule in 25-year-old man. (B) The suture was tied to the labrum with a non-sliding knot after the arthroscopic capsular plication.

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