THE CAPSULAR IMBRICATION PROCEDURE FOR RECURRENT ANTERIOR INSTABILITYOF THE SHOULDER

One hundred and thirty-eight patients (142 shoulders) who had recurren t anterior instability of the shoulder that was unresponsive to a spec ific physician-directed rehabilitation program were managed with an an atomical capsular imbrication reconstruction, The procedure included r epair of the capsulolabral injury when present, and reinforcement of t he anteroinferior capsular ligaments with an imbrication technique tha t decreases the over-all capsular volume, The shoulders were divided i nto two groups: 108 shoulders in which the recurrent instability was r elated to a defined traumatic episode (Group I) and thirty-four should ers with no distinct history of trauma (Group II). The anatomical caps ular imbrication was the primary procedure in ninety shoulders and was used to treat at least one failed previous reconstruction in fifty-tw o shoulders. According to the grading system of Rowe et al., 93 per ce nt (132) of the shoulders had a good or excellent result at an average of five years (range, two to twelve years) after the operation, The r esults after a previous failed reconstruction were especially encourag ing, Of the fifty-two shoulders that had had at least one previous rec onstructive procedure, forty had an excellent result, five had a good result, four had a fair result, and three had a poor result, The resul ts of this study suggest that this procedure restores stability while preserving a functional range of motion in patients who have symptomat ic recurrent anterior instability of the shoulder, regardless of the e tiology.