Original Articles
Laser-assisted capsulorrhaphy for multidirectional instability of the shoulder*

https://doi.org/10.1053/jars.2001.20663Get rights and content

Abstract

Purpose: The purpose of this study was to review the clinical results of laser-assisted capsulorrhaphy performed on 27 shoulders in 26 patients for multidirectional shoulder instability with minimum follow-up of 2 years. Type of Study: Prospective case series. Methods: Laser shrinkage was performed on the entire capsule. In patients in whom the rotator interval did not shrink, suture plication of this area was performed. All patients were evaluated with respect to the incidence of recurrent instability, need for reoperation, and ability to return to their previous level of activity or sports participation. In addition, all patients were rated as satisfactory or unsatisfactory using criteria established by Neer. Results: Twenty-six of 27 shoulders (96%) remained stable and asymptomatic a minimum of 2 years after surgery. Of 14 athletes in the study group, 12 (86%) returned to their previous level of sports participation. Conclusion: Our results suggest that laser-assisted capsulorrhaphy is an effective treatment alternative for multidirectional instability.

Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 1 (January), 2001: pp 25–30

Section snippets

Methods

A retrospective study was initiated for all patients with MDI who required surgical treatment from December 1995 to October 1996. Thirty-two patients were treated with laser-assisted capsulorrhaphy for MDI over this time period. Six patients who were found at arthroscopy to have anterior or posterior labral or capsular tears that required repair were excluded, leaving 26 patients to comprise the study group. All patients were available for follow-up, which averaged 27 months (range, 24 to 35

Results

We reviewed the clinical results of 26 patients who underwent laser-assisted capsulorrhaphy for MDI. All patients were available for follow-up, which averaged 27 months. At the time of most recent follow-up, the presence of recurrent instability, the need for reoperation, and the ability to return to the previous level of activity or sports participation was documented. In addition, all patients were rated as satisfactory or unsatisfactory using the criteria established by Neer and Foster

Discussion

In 1980, Neer and Foster1 described the pathologic capsular hyperlaxity and increased capsular volume associated with MDI and they introduced the inferior capsular shift for treatment of MDI. Forty shoulders in 36 patients with MDI were treated with a humerus-based inferior capsular shift with 17 shoulders having more than 2-year follow-up. One patient (3%) developed recurrent instability anteriorly, which was attributed to a Bankart lesion that was not repaired.

Altchek et al.3 treated 42

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*

Address correspondence and reprint requests to Felix H. Savoie III, M.D., 1325 East Fortification St, Jackson, MS 39202, U.S.A. E-mail: [email protected]

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