ISOLATED CLOSURE OF ROTATOR INTERVAL DEFECTS FOR SHOULDER INSTABILITY

Fifteen patients noted at surgery to have an isolated defect in the ro tator interval and no other pathologic abnormality underwent closure o f the defect as an isolated procedure for recurrent instability sympto ms, Intraoperative assessment of each of these shoulders after the clo sure demonstrated adequate stability, and no other stabilization proce dures were performed. The average age of the patients was 24 years, an d 10 of the 15 patients were women. Examination under anesthesia revea led increased inferior translation in all patients, as illustrated by at least a 1+ sulcus sign. The rotator interval defect averaged 2.75 c m in width and 2.3 cm in height. The rotator interval defect edges wer e freshened and approximated (nine patients) or imbricated (six patien ts), depending on the anterior capsular laxity and the degree of gleno humeral joint translation possible, Followup averaged 3.3 years (range , 2.2 to 5.3), and all patients achieved either a good or excellent re sult using the American Shoulder and Elbow Surgeons evaluation scale a nd the Rowe rating scale, Although most patients with a defect in the rotator interval require a standard stabilization procedure as a suppl ement to closure of the defect, approximation or imbrication of the de fect as an initial step at surgery may confer adequate stability in se lected patients and obviate the need for formal capsular advancement.