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Department of Orthopaedic Surgery, Hannover Medical School, Hannover, Germany
* Address correspondence and reprint requests to Christof Hurschler, PhD, Orthopädische Klinik der Medizinische Hochschule Hannover, Annastift-Heimchenstr. 1–7, D-30625 Hannover, Germany
The effect of a medially based anterior capsular shift on translational and rotational range of motion and posterior capsular strain was investigated in an in vitro model. Six cadaveric shoulders were tested in a robot-assisted shoulder simulator. Translational and rotational range of motion were reduced by the capsular shift, particularly with the shoulder at higher elevation angles. At 60° of elevation, anterior translation was decreased 1.9 ± 2.9 mm, and posterior translation was decreased 2.3 ± 6.2 mm. External rotation was decreased 11.5° ± 10.2°, and internal rotation was decreased 8.9° ± 5.7°. Posterior capsular strain change was dependent on elevation angle. At 30° of elevation, strain tended to increase 5.0% ± 7.3% in the inferior aspect and 2.9% ± 2.6% in the superior aspect, with no change detected in the medial aspect. At 60° of elevation, strain increased 6.6% ± 8.0%, 3.2% ± 2.6%, and 4.4% ± 3.5% in the inferior, middle, and superior aspects, respectively. Our results support the use of the medially based anterior shift for shoulders with anterior-inferior instability or multidirectional instability with posterior involvement.
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