Arthroscopic shoulder capsulorraphy: Does it work?

Abstract

The purpose of this project was to answer the question, "Can shoulder instability be dealt with safely and effec tively arthroscopically?" This study, which began in December 1982 and concluded in February 1985, in volved 12 patients, 3 females and 9 males whose ages ranged from 14 to 40 years. Followup ranged from 31 to 63 months, the average being 44.8 months. The arthroscopic procedure was based on the use of a tool designed to capture the capsule, thus allowing place ment of either one or two low profile extraarticular staples in the capsule. Two cases were failures. The remaining 10 patients were pleased with their operation. Based on the clas sification of Rowe et al., functional results were six excellent, two good, two fair, and two poor. The six patients with excellent results had shoulders of normal appearance. They were fully active and had neither pain nor limitation of motion. All six patients had negative apprehension signs. The two patients with good results had similar outcomes, but they had occasional morning stiffness and intermittent mild pain, as well as a 10° limitation of external rotation in both adduction and abduction. One patient who had a fair result had a positive apprehension sign and occasional pain with quick motion. The other patient with a fair result was hampered by more significant pain on an intermittent basis, yet the pain was not a constant issue. None of these patients had radiographic evidence of increased degenerative changes of the shoulder or staple migra tion. There were two complications and two failures. The answer to the question, "Can shoulder instability be dealt with safely and effectively arthroscopically?", is a qualified yes. For patients who want to avoid the morbidity of an open operation, the results of study suggest that arthroscopic shoulder stabilization can be a safe and reasonably effective alternative to open surgery.