CAPSULORRHAPHY THROUGH AN ANTERIOR APPROACH FOR THE TREATMENT OF ATRAUMATIC POSTERIOR GLENOHUMERAL INSTABILITY WITH MULTIDIRECTIONAL LAXITYOF THE SHOULDER
Ma. Wirth et al., CAPSULORRHAPHY THROUGH AN ANTERIOR APPROACH FOR THE TREATMENT OF ATRAUMATIC POSTERIOR GLENOHUMERAL INSTABILITY WITH MULTIDIRECTIONAL LAXITYOF THE SHOULDER, Journal of bone and joint surgery. American volume (Print ed.), 80A(11), 1998, pp. 1570-1578
Between June 1983 and March 1992, we performed a capsular reconstructi
on procedure through an anterior approach in ten patients (ten shoulde
rs) who had multidirectional laxity of the shoulder and symptomatic at
raumatic posterior glenohumeral instability, The procedure included cl
osure of the capsule in the rotator interval and imbrication of the an
terior, inferior, and posteroinferior aspects of the capsule by a doub
le-breasting technique that decreases the overall capsular volume. The
mean duration of follow-up was sixty months (range, twenty-four to 10
3 months). According to the system of Rowe and Zarins, the result was
graded as excellent for five shoulders, good for four, and poor for on
e. On the basis of our results, we recommend capsular reconstruction t
hrough an anterior approach only in patients who have persistent multi
directional laxity and symptomatic atraumatic posterior instability of
the shoulder despite participation in an intensive rehabilitation pro
gram.