Arthroscopic Posterior Glenohumeral Capsular Augmentation With Gracilis Tendon Allograft

Abstract

Recurrent shoulder instability complicated by capsular insufficiency due to underlying soft-tissue disorders or multiple prior failed surgical procedures poses a challenging surgical problem. Traditional capsulolabral soft-tissue reconstruction techniques are less effective in this setting, and bony procedures sacrifice normal anatomic relations. The described arthroscopic technique aims to prevent instability while maintaining range of motion through creation of a soft-tissue allograft "sling" augmenting the posterior glenohumeral capsule.

Anterior Shoulder Ligamentoplasty as a Treatment for Multidirectional Shoulder Instability

“…A multitude of treatment options are available for complex cases of multidirectional instability occurring in patients with traumatic or atraumatic instability and associated multidirectional hyperlaxity. 1 , 2 , 3 , 4 , 5…”

“… 6 Traditional capsulolabral soft-tissue reconstruction techniques are less effective in this setting, and bony procedures sacrifice normal anatomic relations. 2 Currently, there is an absence of high-level evidence supporting the effectiveness of these methods, and the best treatment option for these patients. 7 …”