Arthroscopic reinforced capsular shift of anterior shoulder instability.

Abstract

This article presents an arthroscopic inferior capsular shift technique. In this technique, the same type of inferior capsular shift as with the open standard Neer procedure can be performed. After standard diagnostic shoulder arthroscopy, a bone trough is made along the capsular attachment to the humeral head using an abrader. An inverted L-shaped incision is performed in the anterior capsule. A suture is passed through the apex of this triangular flap, which is then pulled up and tied over the upper edge of the subscapularis, thus reducing the size of the wide anterior capsule. No hardware implants are used, and the procedure is not technically complicated. The surgery required fewer steps than open repair. The advantages of this technique are the preservation of the subscapularis, faster rehabilitation, and earlier return to normal activities, including sports. It also causes less postoperative range of motion limitation, while offering the same amount of capsular shift as the traditional open repair.