RESULTS OF POSTEROINFERIOR CAPSULAR SHIFT IN PATIENTS WITH POSTERIOR SHOULDER INSTABILITY

Purpose: The purpose of this study was the evaluation of our results a fter posteroinferior capsular shift in patients with a posterior shoul der instability.Materials and methods: In a prospective study we evalu ated 12 patients (14 shoulder joints) with recurrent posterior shoulde r dislocations who were stabilized by a postero-inferior capsular shif t procedure. For the clinical documentation the Rowe-Score, the ASES-S core and the SF-36 were used. Furthermore the patients were submitted to standardized EMG-, isokinetic and proprioceptive tests. Results: Af ter an average follow-up of 22.2 months there were two recurrences whi ch occurred during the first postoperative year. The Rowe-Score improv ed from 46.25 to 76.34 points. The ASES-Score showed an average of 42. 43 points preoperatively and at the time of follow-up an average of 78 .86 points. Most parameters of the ASES-Score as well as the score in total had a constant positive tendency. Only the subjective rating of stability showed a slight decrease after the first six months due to t he two redislocations. But even the stable shoulder joints demonstrate d limitations when throwing a ball. The SF-36 showed a definite gain i n the overall quality of living as well. The EMG-tests at follow-up sh owed a deficit for the patients compared with a control group; even mo re for the female than for the male patients. Similar tendencies were found with the isokinetic strength. The proprioception did not show an y differences between the patients and the control group. Conclusion: With adequate patient selection and after failure of all possible cons ervative treatments the posteroinferior capsular shift is a therapeuti cal option in recurrent posterior shoulder instability.