A new technique of arthroscopic capsular shift in anterior shoulder instability

We describe a new arthroscopic technique to reinforce the tom inferior glen ohumeral ligament (IGHL) and the elongated capsule to the glenoid rim. The arthroscope is inserted over the superior portal and, after the insertion o f a suture anchor, both limbs are pulled out over the posterior portal. The IGHL is grasped and pulled upward onto the glenoid rim using a suture retr iever clamp inserted over the posterior portal. A 45 degrees curved blunt c lamp (Sidewinder; Arthrex, Naples, FL) coming from the anterior penetrates the IGHL, and 1 end of the suture Limb is given into the branches of the cl amp and pulled out anteriorly. After a second perforation of the capsule, a horizontal suture creating a neolabrum can be placed. This technique allow s a suitable reinforcement of the capsule without intraoperative complicati ons. In cases of capsular elongation, especially a torn IGHL, the capsular instability can be addressed by the described Sidewinder technique. More so phisticated arthroscopic techniques such as this will increase the indicati on for arthroscopic shoulder stabilization.