LONG-TERM OUTCOME OF TREATMENT OF POSTERIOR/INFERIOR SHOULDER INSTABILITY BY POSTERIOR/INFERIOR CAPSULAR SHIFT

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.

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Long-term Outcome after Posterior Opening Glenoid Wedge Osteotomy for Posterior Shoulder Instability Associated with Excessive Glenoid Retroversion

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2021.05.028 ◽

2021 ◽

Author(s):

Manuel Waltenspül ◽

Thomas Häller ◽

Lukas Ernstbrunner ◽

Sabine Wyss ◽

Karl Wieser ◽

...

Keyword(s):

Shoulder Instability ◽

Wedge Osteotomy ◽

Posterior Shoulder Instability ◽

Term Outcome ◽

Long Term Outcome ◽

Posterior Shoulder ◽

Glenoid Retroversion

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Does surgery followed by physiotherapy improve short and long term outcome for patients with atraumatic shoulder instability compared with physiotherapy alone? - protocol for a randomized controlled clinical trial

BMC Musculoskeletal Disorders ◽

10.1186/1471-2474-15-439 ◽

2014 ◽

Vol 15 (1) ◽

Cited By ~ 3

Author(s):

Anju Jaggi ◽

Susan Alexander ◽

Robert Herbert ◽

Lennard Funk ◽

Karen A Ginn

Keyword(s):

Clinical Trial ◽

Shoulder Instability ◽

Controlled Clinical Trial ◽

Randomized Controlled Clinical Trial ◽

Term Outcome ◽

Long Term Outcome ◽

Randomized Controlled ◽

Short And Long Term

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Long-Term Outcome of Rockwood Capsular Shift for Recurrent Shoulder Dislocation

Journal of Orthopaedic Surgery ◽

10.1177/1602400325 ◽

2016 ◽

Vol 24 (3) ◽

pp. 392-397 ◽

Cited By ~ 4

Author(s):

Luigi Murena ◽

Nicola Guindani ◽

Stefano Turino ◽

Federico A Grassi ◽

Paolo Cherubino

Keyword(s):

Shoulder Dislocation ◽

Recurrent Dislocation ◽

Term Outcome ◽

Long Term Outcome ◽

Capsular Shift ◽

Shoulder Range Of Motion ◽

Recurrent Shoulder Dislocation ◽

Glenohumeral Osteoarthritis

Purpose To review the long-term outcome of Rockwood capsular shift for recurrent shoulder dislocation secondary to trauma. Methods Records of 30 males and 4 females who underwent Rockwood capsular shift for recurrent (≥2 episodes) anterior shoulder dislocation were reviewed. An additional Bankart repair with different techniques was performed in 24 of the patients by 2 different surgeons. The outcome was assessed using the Western Ontario Shoulder Instability Index (WOSI) and the Western Ontario Osteoarthritis of the Shoulder (WOOS) index questionnaires, the modified Rowe score, and the Constant-Murley score. Shoulder range of motion (ROM) was measured. Degenerative joint changes were evaluated on radiographs. Results During a mean follow-up of 13 (range, 10–16) years, 6 (18%) patients had a mean of 1.2 recurrent dislocations. Four of the patients reported a traumatic event during recurrent dislocation. Of the 6 patients, 3 had undergone a Bankart lesion repair. Better Rowe and adjusted Constant scores were associated with lower age at first dislocation, at the index surgical procedure, and at follow-up. Four patients developed glenohumeral osteoarthritis: 2 were mild or moderate and 2 were severe and symptomatic. Glenohumeral osteoarthritis was associated with follow-up duration (p=0.03) and poorer Rowe score (p=0.012), adjusted Constant score (p=0.001), and WOOS score (p=0.006). Conclusion Rockwood capsular shift can preserve shoulder ROM, with rates of recurrent dislocation and degenerative joint changes comparable with other techniques.

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