Abstract
Introduction
Patients (n=62) with recurrent traumatic anterior or anteroinferior glenohumeral instability were prospectively evaluated with reference to the surgical reconstruction technique performed.
Materials and methods
Neer’s T-plasty procedure was performed in group I (n=31) while a modified, anatomically orientated, anteroinferior capsular shift was performed in group II (n=31). All patients underwent an additional Bankart repair. After 18.1 (group II) and 22.2 (group I) months, patients were assessed in terms of subjective satisfaction, objective stability, range of motion, and functional outcome.
Results
No significant differences (91.5% group II, 87.8% group I) were noted between the study groups regarding the patient’s subjective evaluation (p=0.17106). Results of Rowe’s (93.1% group II, 87.9% group I; p=0.14419) and Constant’s Score (96.5% group II, 93.8% group I; p=0.16582) showed no significant differences for both collectives. Postoperative lack of external rotation remained significantly smaller in group II (5.6°±2.5°) compared with group I (9.8°±2.5; p=0.00028). Although no significant differences (p=0.612) were found, the rate of recurrence was obviously smaller in group II (group II vs group I: 6 patients).
Conclusions
Our results demonstrate no significant differences between the two capsular reconstruction techniques regarding patient’s satisfaction, Rowe and Constant Scores. However, the anatomically orientated anteroinferior capsular shift leads to a significantly smaller external rotation deficit and seems to offer a more reliable postoperative stability.
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References
Altchek DW, Warren RF, Skyhar MJ, Oritz G (1991) T-plasty modification of the Bankart procedure for multi-directional instability of the anterior and inferior types. J Bone Joint Surg Am 73:105–112
Andrews JR, Satterwhite YE (1993) Anatomic capsular shift. J Orth Techniques 1:151–160
Bankart AB (1939) The pathology and treatment of recurrent dislocation of the shoulder joint. Br J Surg 26:23–29
Berg EE, Ellison AE (1990) The inside-out Bankart procedure. Am J Sports Med 18:129–133
Bigliani LU, Kurzweil PR, Schwartzbach CC, Wolfe IN (1994) Inferior capsular shift procedure for anterior-inferior shoulder instability in athletes. Am J Sports Med 22:578–584
Collins HR, Wilde AH (1973) Shoulder instability in athletics. Orthop Clin North Am 4:759–774
Constant CR, Murley AHG (1987) A clinical method of functional assessment of the shoulder. Clin Orthop 214:160–164
Coughlin L, Rubinovich M, Johansson J, White B, Greenspoon J (1992) Arthroscopic staple capsulorrhaphy for anterior shoulder instability. Am J Sports Med 20:253–256
ElAttrache N, Jobe F, Tibone J (1994) Anterior capsulolabral reconstruction in the treatment of traumatic glenohumeral instability. J Shoulder Elbow Surg 3:54
Hamada K, Fukuda H, Nakajima T, Yamada N (1999) The inferior capsular shift operation for instability of the shoulder. J Bone Joint Surg Br 81:218–225
Harryman DT II, Sidles JA, Clark JM, McQuade KJ, Gibb TD, Matsen FA III (1990) Translation of the humeral head on the glenoid with passive glenohumeral motion. J Bone Joint Surg Am 72:1334–1343
Hawkins RJ, Angelo RL (1990) Glenohumeral osteoarthrosis: a late complication of the Putti-Platt repair. J Bone Joint Surg Am 72:1193–1197
Jobe FW, Giangarra CE, Kvitne RS, Glousman RE (1991) Anterior capsulolabral reconstruction of the shoulder in athletes in overhand sports. Am J Sports Med 19:428–434
Lazarus MD, Harryman DT II (2000) Complications of open stabilization of the shoulder. J Am Acad Orthop Surg 8:122–132
Matsen FA, Thomas SC, Rockwood CA, Wirth MA (1998) In: Rockwood CA, Matsen FA (eds) The shoulder. W.B. Saunders, Philadelphia
Neer CS II, Foster CR (1980) Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder: a prelimary report. J Bone Joint Surg Am 62:897–908
Neer CS II, Fithian TE, Hansen PE, Ogawa K, Brems JJ (1985) Reinforced cruciate repair for anterior dislocation of the shoulder. Orthop Trans 9:44
Paulos LE, Evans IK, Pinkowski JL (1993) Anterior and anterior-inferior shoulder instability: treatment by glenoid labrum reconstruction and a modified capsular shift procedure. J Shoulder Elbow Surg 2:305–313
Rowe CR, Patel D, Southmayd WW (1978) The Bankart procedure: a long-term end-result study. J Bone Joint Surg Am 6:1–16
Rubenstein DL, Jobe FW, Glousman RE, Kvitne RS, Pink M, Giangarra CE (1992) Anterior capsulolabral reconstruction of the shoulder in athletes. J Shoulder Elbow Surg I:229–237
Warner JJ, Johnson D, Miller M, Caborn DN (1995) Technique for selecting capsular tightness in repair of anterior-inferior shoulder instability. J Shoulder Elbow Surg 4:352–364
Warren RF (1985) Instability of the shoulder in throwing sports. Instr Course Lect 34:337–348
Zarins B, Faulks CR, Satterwhite YE (1998) Open operative procedures for shoulder instability in the baseball player. In: Andrews JR, Zarins B, Wilk KE (eds) Injuries in baseball. Lippincott-Raven, Philadelphia, pp 175–188
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Jaeger, A., Braune, C., Welsch, F. et al. Postoperative functional outcome and stability in recurrent traumatic anteroinferior glenohumeral instability: comparison of two different surgical capsular reconstruction techniques. Arch Orthop Trauma Surg 124, 226–231 (2004). https://doi.org/10.1007/s00402-003-0601-1
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DOI: https://doi.org/10.1007/s00402-003-0601-1