ORIGINAL ARTICLE

Inferior capsular shift operation for multidirectional instability of the shoulder in players of contact sports

C-H Choi¹ and D J Ogilvie-Harris²

¹ Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea
² Department of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada

Correspondence to:
Correspondence to:
Dr Ogilvie-Harris, Edith Cavell Wing 1-032, Toronto Western Hospital, 399, Bathurst St, Toronto, Ontario M5T 2S8, Canada;
darrell.ogilvieharris{at}rogers.com

Objectives: To assess the results of inferior capsular shift for multidirectional instability of the shoulder in athletes.

Methods: Multidirectional instability was surgically corrected in 53 shoulders in 47 athletes who engaged in contact sports. A history of major trauma was found in eight patients, the others having had minor episodes. Before surgery, all patients had complex combinations of instabilities. The surgical approach was selected according to the predominant direction of instability.

Results: Anterior inferior capsular shift was carried out in 37 shoulders, and anterior dislocation recurred in three. In one of these, it was anterior alone, one was anterior and inferior, and one was unstable in all three directions. After posterior inferior capsular shift in 16 shoulders, one dislocation occurred anteriorly and one posteriorly. With the anterior approach, four athletes could not return to sport. Two patients treated with the posterior approach could not return to sport. Of these six failures, five patients had had bilateral repairs. Successful repair based on the criteria of the American Shoulder and Elbow Association was achieved in 92% of anterior repairs and 81% of posterior repairs. Successful return to sport was noted in 82% of patients with anterior repairs, 75% with posterior repairs, and 17% with bilateral repairs. Overall, there were five subsequent dislocations, three in the anterior repair group (8%), and two in the posterior repair group (12%).

Conclusions: Inferior capsular shift can successfully correct multidirectional instability in most players of contact sports, but the results in bilateral cases are poor.

Keywords: shoulder; instability; inferior capsular shift; contact sports

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Dewing, C. B., McCormick, F., Bell, S. J., Solomon, D. J., Stanley, M., Rooney, T. B., Provencher, M. T. (2008). An Analysis of Capsular Area in Patients With Anterior, Posterior, and Multidirectional Shoulder Instability. Am J Sports Med 36: 515-522 [Abstract] [Full Text]  
• Bahk, M., Keyurapan, E., Tasaki, A., Sauers, E. L., McFarland, E. G. (2007). Laxity Testing of the Shoulder: A Review. Am J Sports Med 35: 131-144 [Abstract] [Full Text]  
• Marquardt, B., Potzl, W., Witt, K.-A., Steinbeck, J. (2005). A Modified Capsular Shift for Atraumatic Anterior-Inferior Shoulder Instability. Am J Sports Med 33: 1011-1015 [Abstract] [Full Text]  
• Kim, S.-H., Kim, H.-K., Sun, J.-I., Park, J.-S., Oh, I. (2004). Arthroscopic Capsulolabroplasty for Posteroinferior Multidirectional Instability of the Shoulder. Am J Sports Med 32: 594-607 [Abstract] [Full Text]  
• McFarland, E. G., Kim, T. K., Park, H. B., Neira, C. A., Gutierrez, M. I. (2003). The Effect of Variation in Definition on the Diagnosis of Multidirectional Instability of the Shoulder. JBJS 85: 2138-2144 [Abstract] [Full Text]