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The American Journal of Sports Medicine 33:1011-1015 (2005)
© 2005 American Orthopaedic Society for Sports Medicine

A Modified Capsular Shift for Atraumatic Anterior-Inferior Shoulder Instability

Björn Marquardt, MD*,{dagger}, Wolfgang Pötzl, MD{dagger}, Kai-Axel Witt, MD{ddagger} and Jörn Steinbeck, MD{ddagger}

From the {dagger} Department of Orthopaedics, University Hospital of Münster, Münster, Germany, and the {ddagger} Shoulder and Sportsmedicine Practice-Clinic, Münster, Germany

* Address correspondence to Björn Marquardt, MD, Department of Orthopaedics, University Hospital of Muenster, Albert-Schweitzer Str.33, 48149 Münster, Germany (e-mail: bjoern.marquardt{at}t-online.de).

Purpose: To evaluate the long-term outcome of a modified inferior capsular shift procedure in patients with atraumatic anterior-inferior shoulder instability by analyzing a consecutive series of patients who had undergone a modified inferior capsular shift for this specific type of shoulder instability.

Study Design: Case series; Level of evidence, 4.

Methods: Between 1992 and 1997, 38 shoulders of 35 patients with atraumatic anterior-inferior shoulder instability that were unresponsive to nonoperative management were operated on using a modified capsular shift procedure with longitudinal incision of the capsule medially and a bony fixation of the inferior flap to the glenoid and labrum in the 1 o’clock to 3 o’clock position. The patient study group consisted of 9 men and 26 women with a mean age of 25.4 years (range, 15–55 years) at the time of surgery. The mean follow-up was 7.4 years (range, 4.0–11.4 years); 1 patient was lost to follow-up directly after surgery. The study group was evaluated according to the Rowe score.

Results: After 7.4 years, 2 patients experienced a single redislocation or resubluxation, 1 patient had recurrent dislocations, and 1 patient had a positive apprehension sign, which is an overall redislocation rate of 10.5%. The average Rowe score increased to 90.6 (SD = 19.7) points from 36.2 (SD = 13.5) points before surgery. Seventy-two percent of the patients participating in sports returned to their preoperative level of competition.

Conclusions: Results in this series demonstrate the efficacy and durability of a modified capsular shift procedure for the treatment of atraumatic anterior-inferior shoulder instability.

Key Words: shoulder instability • atraumatic • capsular shift




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