| The Mid-term Results of Inferior Capsular Shift Procedure for Multidirectional Instability of the Shoulder |
| Yong Girl Rhee, M.D., Chang Hyun Cho, M.D., Jae Hoon Lee, M.D. |
| Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea |
| 견관절 다방향 불안정성의 하방 관절낭 이동술에 대한 중간 추시 결과 |
| 이용걸, 조창현, 이재훈 |
| 경희대학교 의과대학 정형외과학교실 |
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| Abstract |
Purpose
: To report the mid-term results of the inferior capsular shift procedure for the multidirectional instability, and to analyze whether the bilateral laxity, the generalized ligamentous laxity and the voluntary instability can influence upon the final outcome. Material and Method : We reviewed 95 patients with 96 shoulders treated by the inferior capsular shift procedure for multidirectional instability through an anterior approach. In total, 49 shoulders(51%) showed generalized ligamentous laxity, 56 shoulder (58%) bilateral laxity, and 65 shoulders(68%) voluntary subluxation. Mean follow-up was 27 months(11~60 months). Result : The final Rowe score was 75 points in patients who had had at least one of the bilateral laxity, generalized ligamentous laxity, or the voluntary subluxation and 84 points without any of these in each element. Seventy-five percent of the bilateral laxity and 87% of the unilateral instability continued to function well without any pain and instability postoperatively. Those with a voluntary(74%), those with an involuntary instability(83%), those with a generalized ligamentous laxity(73%) and without laxity(84%) could do well a daily living activity without instability. Eighty-six percent who had had the voluntary instability was eliminated completely the voluntability. Eighty-four percent of the patients stated that they were subjectively satisfied with the status of their shoulder. Nine shoulders(9.4%) had recurrence of symptomatic and disabling instability and theses patients had had at least voluntary instability preoperatively. Seven patients(7.3%) suffered from the stiff shoulder after the inferior capsular shift procedure. Conclusion : The inferior capsular shift procedure in multidirectional instability provided satisfactory results both in objective and subjective terms. Nonetheless, a patient who has a bilateral laxity, a generalized ligamentous laxity or a voluntary instability could be expected less favorable results compared to those with neither of these. A careful selection of the inferior capsular shift procedure for the multidirectional instability is needed before surgery. But our results suggests that a voluntary instability is not always poor candidate for the inferior capsular shift procedure. |
| Key Words:
Shoulder, Mutidirectional instability, Inferior capsular shift |
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