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

Jin Woong Yi; Nam Su Cho; Eun Suck Son; Yong Girl Rhee

doi:10.4055/jkoa.2009.44.1.29

Journal List > J Korean Orthop Assoc > v.44(1) > 1012904

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Yi, Cho, Son, and Rhee: Comparison of Open and Arthroscopic Inferior Capsular Shifts for Multidirectional Instability of the Shoulder

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2009; 44(1): 29-36.

Published online: 23 February 2009

DOI: https://doi.org/10.4055/jkoa.2009.44.1.29

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

Jin Woong Yi, M.D., Nam Su Cho, M.D.^*, Eun Suck Son, M.D.^†, Yong Girl Rhee, M.D.^†

Department of Orthopaedic Surgery, School of Medicine, Konyang University, Daejeon, Korea.

^*Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, East-West Neo Medical Center, Seoul, Korea.

^†Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.

Address reprint requests to Yong Girl Rhee, M.D. Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, 1, Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea. Tel: +82.2-958-8370, Fax: +82.2-958-3865, shoulderrhee@hanmail.net

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 173.7° preoperatively and 166.1° postoperatively. External rotation on the side changed from 75.5° to 62.7°. 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 169.5° preoperatively and 171.2° postoperatively. External rotation changed from 70.8° to 61.4°.

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.

Keywords: Shoulder, Multidirectional instability, Inferior capsular shift

Figures and Tables

Fig. 1

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

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.

Table 1

Patients' Demography

Mo, month; yr, year; Hx, history.

Table 2

Comparison of Results of the Open and Arthroscopic Procedures

VAS, visual analogue score.

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