The selective capsular repair for anterior shoulder instability allows
the surgical technique to address the pathology encountered. An initi
al transverse capsulotomy allows visualization of the joint and flexib
ility in determining the site of the repair. The capsular tensioning c
an be performed either medially or laterally as determined by the pres
ence of a Bankart lesion. Examination of the joint following the proce
dure should reveal the elimination of the pathologic anterior translat
ion, reduction in the inferior translation, and the degree of external
rotation desired to meet the specific goals of the patient.