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Am J Sports Med. 2003 Mar-Apr;31(2):247-52.

Anteromedial capsular redundancy and labral deficiency in shoulder instability.

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  • 1Center for Shoulder, Elbow, and Sports Medicine, Department of Orthopaedic Surgery, New York Orthopaedic Hospital, Columbia-Presbyterian Medical Center, New York, New York 10032, USA.

Abstract

BACKGROUND:

Redundancy of the anteromedial capsule of the shoulder may persist despite proper tensioning of the capsule and repair of a Bankart lesion during an anteroinferior capsular shift procedure.

HYPOTHESIS:

A barrel-stitch suture technique incorporated into a capsular shift procedure is effective in achieving satisfactory shoulder stability.

STUDY DESIGN:

Uncontrolled retrospective review.

METHODS:

A barrel-stitch technique was used for patients identified as having anteromedial capsular redundancy during a capsular shift procedure for anteroinferior instability.

RESULTS:

The incidence of anteromedial capsular redundancy and labral deficiency was 49% (38 of 78). Patients with anteromedial capsular redundancy had a significantly greater number of dislocations before surgery (16.1 +/- 21.3 versus 7.4 +/- 7.4) and a greater duration of symptoms (79.8 +/- 84.2 versus 31.6 +/- 32.2 months). The mean postoperative Rowe score of patients with anteromedial capsular redundancy was 88.7 +/- 14.8, with 92% having excellent or good results, compared with 88.9 +/- 14.8 in the remaining patients and 93% excellent or good results.

CONCLUSIONS:

Anteromedial capsular redundancy is associated with longer preoperative duration of symptoms and more dislocations, but effective treatment can be achieved with a capsular shift procedure augmented with medial capsular imbrication with a barrel stitch.

Copyright 2003 American Orthopaedic Society for Sports Medicine

PMID:
12642260
[PubMed - indexed for MEDLINE]
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