Outcomes After Arthroscopic Pancapsular Capsulorrhaphy With Suture Anchors for the Treatment of Multidirectional Glenohumeral Instability in Athletes

Raynor, Martin B.; Horan, Marilee P.; Greenspoon, Joshua A.; Katthagen, J. Christoph

doi:10.1177/0363546516659644

Cited by 27 publications

(28 citation statements)

References 28 publications

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“…Although a few studies have assessed outcomes after the arthroscopic treatment of MDI, 3,24,29,30 there is significant variation in the definition of MDI, 20 and this diagnosis does not necessarily coincide with concomitant anterior and posterior instability. To our knowledge, no studies have assessed the outcomes specifically of patients undergoing arthroscopic combined anterior and posterior stabilization, making this the first study to do so.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Return to Sport After Arthroscopic Anterior, Posterior, and Combined Shoulder Stabilization

Kraeutler

Aberle

Brown

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:Glenohumeral instability is a common abnormality, especially among athletes. Previous studies have evaluated outcomes after arthroscopic stabilization in patients with anterior or posterior shoulder instability but have not compared outcomes between groups.Purpose:To compare return-to-sport and other patient-reported outcomes in patients after primary arthroscopic anterior, posterior, and combined anterior and posterior shoulder stabilization.Study Design:Cohort study; Level of evidence, 3.Methods:Patients who underwent primary arthroscopic anterior, posterior, or combined anterior and posterior shoulder stabilization were contacted at a minimum 2-year follow-up. Patients completed a survey that consisted of return-to-sport outcomes as well as the Western Ontario Shoulder Instability Index (WOSI), Single Assessment Numeric Evaluation (SANE), American Shoulder and Elbow Sur’geons (ASES) score, and Shoulder Activity Scale.Results:A total of 151 patients were successfully contacted (anterior: n = 81; posterior: n = 22; combined: n = 48) at a mean follow-up of 3.6 years. No significant differences were found between the groups with regard to age at the time of surgery or time to follow-up. No significant differences were found between the groups in terms of WOSI (anterior: 76; posterior: 70; combined: 78; P = .28), SANE (anterior: 87; posterior: 85; combined: 87; P = .79), ASES (anterior: 88; posterior: 83; combined: 91; P = .083), or Shoulder Activity Scale (anterior: 12.0; posterior: 12.5; combined: 12.5; P = .74) scores. No significant difference was found between the groups in terms of the rate of return to sport (anterior: 73%; posterior: 68%; combined: 75%; P = .84).Conclusion:Athletes undergoing arthroscopic stabilization of anterior, posterior, or combined shoulder instability can be expected to share a similar prognosis. High patient-reported outcome scores and moderate to high rates of return to sport were achieved by all groups.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Return to Sport After Arthroscopic Anterior, Posterior, and Combined Shoulder Stabilization

Kraeutler

Aberle

Brown

et al. 2018

Orthopaedic Journal of Sports Medicine

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“…In order to avoid falling into the group called AIOS, we excluded patients who suffered the dislocation because of over-head sporting activity. Raynor et al 20 compared the outcomes of an arthroscopic pancapsular capsulorraphy with suture anchors for the treatment of patients with atraumatic and traumatic multidirectional instability. At final follow-up, at least 2 years out from surgery, patients with traumatic onsets demonstrated higher scores, fewer subluxations and were significantly more satisfied than those with atraumatic onsets.…”

Section: Discussionmentioning

confidence: 99%

“…It was not possible to contact two patients. Ten patients (83% of the total) were clinically re-evaluated -7 women and 3 men with a mean age at evaluation of 27.9 years (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35), and a mean age at surgery of 25.8 years (17-33). All patients had followed specific rehabilitation protocols for at least 6 months obtaining such unsatisfying results to require further surgery.…”

Section: Methodsmentioning

confidence: 99%

Arthroscopic treatment of the atraumatic shoulder instability: a case series with two-year follow-up evaluation

Gervasi

Sebastiani

Cautero

et al. 2019

Muscle Ligaments and Tendons J

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Background: The purpose of this work is to evaluate the results of arthroscopic capsulolabroplasty in patients affected by atraumatic shoulder instability (ASI). Methods: A retrospective review was performed of 10 patients (7 women and 3 men) who underwent arthroscopic treatment of symptomatic ASI. Mean age at evaluation was 27.9 (19-35) years and the mean follow-up was 23.3 (12-37) months. We evaluated recurrence rate, range of movement, apprehension and relocation tests, hyperlaxity, and sport activity. The ASES score, the Rowe score, the Simple Shoulder Test (SST) and Visual Analogue Scale (VAS) were also used as outcomes measure. Results: None of the patients experienced episodes of dislocation or subluxation after surgery. The apprehension and relocation tests produced positive results in 2 patients. Six out of 10 patients reported apprehension with the arm in specific positions. The ASES mean score was 93.4 (55-100); the Rowe mean score was 85.5 (70-100); the SST mean score was 9. 1 (5.8-10). On average, external rotation is reduced by 10° in adduction, and by 8° in abduction in 6 out of 10 patients; internal rotation is reduced on average by 6.6° in abduction with the arm abducted, and was overall limited in 6 out of 10 patients. Conclusions: Arthroscopic capsulolabroplasty ensures excellent results in patients showing atraumatic shoulder instability in terms of recurrence. Still, an underlying insecurity persists and the risk of residual stiffness is tangible. Level of evidence: V.

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“…described a modified capsular shift technique, termed the “T-plasty,” in which the anterior capsule is shifted on its medial (glenoid) attachment, simultaneously reducing anteroinferior capsular laxity and reducing the Bankart lesion on the anterior glenoid margin. Rotator interval closure (RIC) has also been used to successfully augment surgical treatment for MDI 2, 10, 11. The open technique of Harryman et al 12 .…”

mentioning

confidence: 99%

“…Rotator interval closure (RIC) has also been used to successfully augment surgical treatment for MDI. 2,10,11 The open technique of Harryman et al 12 imbricates and reinforces the coracohumeral ligament and superior glenohumeral ligament, tightening the rotator interval by approximately 1 cm. In patients with hyperlaxity due to connective tissue disorders, these techniques can be used effectively in combination to improve shoulder stability.…”

mentioning

confidence: 99%

Multidirectional Shoulder Instability With Bone Loss and Prior Failed Latarjet Procedure: Treatment With Fresh Distal Tibial Allograft and Modified T-Plasty Open Capsular Shift

Peebles

Aman

Preuss

et al. 2019

Arthroscopy Techniques

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Recurrent multidirectional shoulder instability (MDI) is a challenging clinical problem, particularly in the setting of connective tissue diseases, and there is a distinct lack of literature discussing strategies for operative management of this unique patient group. These patients frequently present with significant glenoid bone loss, patulous and abnormal capsulolabral structures, and a history of multiple failed arthroscopic or open instability procedures. Although the precise treatment algorithm requires tailoring to the individual patient, we have shown successful outcomes in correcting recurrent MDI in the setting of underlying connective tissue disorders by means of a modified T-plasty capsular shift and rotator interval closure in conjunction with distal tibial allograft bony augmentation. The purpose of this Technical Note was to describe a technique that combines a fresh distal tibial allograft for glenoid bony augmentation with a modified T-plasty capsular shift and rotator interval closure for the management of recurrent shoulder MDI in patients presenting with Ehlers-Danlos syndrome or other connective tissue disorders after failed Latarjet stabilization.

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Outcomes After Arthroscopic Pancapsular Capsulorrhaphy With Suture Anchors for the Treatment of Multidirectional Glenohumeral Instability in Athletes

Cited by 27 publications

References 28 publications

Clinical Outcomes and Return to Sport After Arthroscopic Anterior, Posterior, and Combined Shoulder Stabilization

Clinical Outcomes and Return to Sport After Arthroscopic Anterior, Posterior, and Combined Shoulder Stabilization

Arthroscopic treatment of the atraumatic shoulder instability: a case series with two-year follow-up evaluation

Multidirectional Shoulder Instability With Bone Loss and Prior Failed Latarjet Procedure: Treatment With Fresh Distal Tibial Allograft and Modified T-Plasty Open Capsular Shift

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