Arthroscopic anterior shoulder stabilization: combined multiple suture repair and laser-assisted capsular shrinkage.

Abstract

The results of laser-assisted capsular shrinkage (LACS) in combination with arthroscopic refixation of the capsulolabral avulsion are compared to those of an arthroscopic Bankart repair alone. In a prospective study, an arthroscopic LACS in combination with a multiple suture capsulolabral refixation according to Caspari and Savoie (Am. J. Sports Med. 12 (1984) 283) was performed from July 1997 to April 1999 on 22 nonselected patients. The clinical results were compared to those of 20 patients following anterior shoulder stabilization according to Caspari without LACS from January 1992 to June 1997. The average follow-up was 59 (21-81) months for the Caspari only and 24 (7-48) months for the Caspari + LACS-group. The observed redislocation rate was reduced to 5% (1/22) through the additional capsular shrinkage, from the initially observed 25% (5/20) of the Caspari only group. A total of 82% of the patients with additional laser shrinkage had a "very good" or "good" outcome when evaluated by Young and Rockwood (J. Bone Joint Surg.73 A (1991) 1) shoulder score, compared to 50% after capsulolabral repair alone. The data show that a capsulolabral repair in combination with LACS provides significantly better clinical results and a lower recurrence rate than the capsulolabral repair alone.