Treatment of recurrent post-traumatic anterior-inferior glenohumeral instabilities with the selective capsular shift technique

Objectives: We evaluated the functional results of treatment with the selective capsular shift technique in patients with recur¬rent post-traumatic anterior-inferior glenohumeral instability. Methods: The study included 16 patients (15 males, 1 female; mean age 30 years; range 25 to 38 years) who underwent selec¬tive capsular shift operation for recurrent post-traumatic anteri¬or-inferior glenohumeral instability. Dislocations occurred fol¬lowing severe (n=14) or mild (n=2) trauma. Preoperatively, the mean number of dislocations was 14 (range 4 to 45) and mag¬netic resonance imaging showed a Bankart lesion in all the patients and a Hill-Sachs lesion in 20%. The patients were eval¬uated according to the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and Roweʹs scoring for Bankart repair. Preoperative and postoperative anteroposterior and axillary x-rays were obtained from all the patients. Range of motion was measured with a goniometer and manual muscle strength tests were performed. The mean fol¬low-up was 41 months (range 21 to 74 months). Statistical analysis was made using the t-test. Results: The mean preoperative and postoperative ASES scores differed significantly (63.2 vs 95.8; p<0.05). The mean Rowe score was 92.5 (range 70 to 100). Strength of the infraspinatus, supraspinatus, and subscapularis muscles increased significantly (p<0.05). The results were excellent in 12 patients (75%), good in two patients (12.5%), and fair in two patients. Fifteen patients (93.8%) expressed satisfac¬tion with the operation and results. Conclusion: Addition of the selective capsular shift technique to the Bankart repair procedure improves stability and pre¬serves the range of motion of the glenohumeral joint in patients with anterior-inferior glenohumeral instability accompanied by a Bankart lesion and capsular injury or laxity.