Inferior capsular shift for multidirectional instability following failed laser-assisted capsular shrinkage

This report is a prospective study of 10 consecutive patients treated by open inferior capsular shift following failed laser-assisted capsular shrinkage. Six patients had true multidirectional instability, 2 had anteroinferior instability with multidirectional laxity, and 2 had posteroinferior instability with multidirectional laxity. An anterior approach was used and a humeral side capsular shift performed. The mean period of follow-up was 33 months (range, 18-47 months). On the basis of the Rowe system, 9 patients had excellent results and 1 had a poor result at final follow-up. The mean score improved from 37.5 to 94 points on the Rowe scale, from 73 to 90.4 points on the Constant scale, and from 1.6 to 7.7 points on a numeric satisfaction scale (P<0.001 for all). The one poor result was in the only patient who underwent multiple attempts at open stabilization prior to laser-assisted capsular shrinkage. There were no complications. We conclude that the results of an inferior capsular shift for multidirectional instability are not necessarily adversely affected by a previous failed laser-assisted capsular shrinkage procedure.

(J Shoulder Elbow Surg 2002;11:305-8)