THE ARTHROSCOPIC TREATMENT OF MULTIDIRECTIONAL SHOULDER INSTABILITY -2-YEAR RESULTS OF A MULTIPLE SUTURE TECHNIQUE

Nineteen consecutive shoulders in 19 patients were treated for multidi rectional shoulder instability with an arthroscopic capsular shift. In dications for the procedure included complaints of pain, instability, or both that was unresponsive to a prescribed exercise program that st ressed rotator cuff and scapular stabilizer strengthening. All patient s had evidence of increased joint laxity on physical examination; 17 h ad a 2+ or greater sulcus test and 2 had 3+ laxity both anteriorly and posteriorly. Fourteen of the 19 patients were injured during athletic activity, All surgeries were performed in an outpatient setting. All the patients were evaluated at an average of 34 months postoperatively with a minimum follow-up of 25 months, Based on the outcome scale des cribed by Tibone and Bradley, the average postoperative score was 91 o ut of a possible 100 with 13 excellent, 5 good, and 1 fair result. All but 1 of the athletes returned to their previous level of performance but none were elite throwers. One patient had recurrent anterior subl uxations treated with a repeat arthroscopic capsular shift and was rat ed as good. The patient rated as fair had no improvement in her pain a fter surgery. One patient complained of a painful supraclavicular sutu re that resolved spontaneously, There were no neurovascular complicati ons or infections. Visualization of intra-articular pathology was enha nced with the arthroscope and aided in the diagnosis of multidirection al instability. The described technique proved safe and effective in t reating multidirectional instability and enabling athletes to return t o their previous level of function.