Inferior Capsular Shift Procedure for Anterior-inferior Shoulder Instability in Athletes*

Abstract

Sixty-eight shoulders in 63 athletic patients with anterior-inferior glenohumeral instability underwent an anterior-inferior capsular shift procedure. Shoulders with glenoid fractures, predominantly posterior instabil ity, or routine, unidirectional anterior instability were not included in this study. There were 42 men and 21 women, with an average age of 23 years. Forty-two re pairs were performed on the dominant arm. All 31 over head throwing athletes had their dominant arms re paired. Forty-six shoulders had histories of recurrent anterior dislocations, while 22 shoulders had recurrent subluxation. All 68 shoulders had an anterior-inferior capsular shift, tailored to the degree of laxity found; in addition, 21 had repair of a Bankart lesion. Forty-two patients were rated excellent (67%), 17 good (27%), 2 fair (3%), and 1 poor (3%). Fifty-eight of 63 (92%) pa tients returned to their major sports, 47 (75%) at the same competitive levels. Only 5 of 10 elite throwing ath letes returned to their prior competitive levels. Loss of external rotation averaged 7°. Two patients (2.9%) re- dislocated postoperatively, after violent falls.