Glenohumeral joint volume reduction with progressive release and shifting of the inferior shoulder capsule

Wiater, J. Michael; Vibert, Brady

doi:10.1016/j.jse.2007.02.117

Cited by 28 publications

(28 citation statements)

References 21 publications

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“…Their volume reduction potential has been evaluated in cadavers. Open procedures can reduce the volume by 46-66 % [12,[14][15][16][17]. Arthroscopic techniques have been found to have less potential for decreasing the volume-by 16-19 % [13,15,21].…”

Section: Discussionmentioning

confidence: 99%

“…To our best knowledge there has been no report on volume reduction effect in the clinical in vivo scenario in arthroscopic stabilization techniques apart from our technical report on arthroscopic capsular shift [22]. Such evaluation would provide proper knowledge of how the surgical techniques affect the joint biomechanics and the anatomy of the glenohumeral joint [12][13][14][15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 94%

“…Capsular shift is intended to decrease volume, thus constraining the joint. The potential to reduce the joint volume has been studied before on a cadaveric shoulder model [12][13][14][15][16][17][18][19][20][21], showing that open techniques allow for higher volume reduction (40-50 %) than arthroscopic techniques (30-40 %). However, a cadaveric shoulder may not reflect a life scenario of the unstable shoulder in a much younger population and different joint capacity despite the fact that various modifications of arthroscopic techniques have been published to make either capsular shift or plication.…”

Section: Introductionmentioning

confidence: 99%

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Effect of arthroscopic techniques on joint volume in shoulder instability: Bankart repair versus capsular shift

Lubiatowski

Długosz

Ślęzak

et al. 2016

International Orthopaedics (SICOT)

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Purpose The evaluation of glenohumeral joint volume in both unstable (with/without laxity) and stable shoulders (subacromial impingement) and volume reduction potential of arthroscopic techniques: (labral anchor repair vs. capsular shift). Methods Material was based on 133 patients: anterior shoulder instability without laxity (group I, n = 49), with laxity (group II, n = 22) and subacromial impingement (control group, n = 62) operated in 2010-2011. Group I received arthroscopic Bankart repair, group; II -arthroscopic anterior capsular plication, control group -subacromial decompression. Joint volume was measured by fluid aspiration into the syringe via arthroscope, before and after procedure. Then volume reduction potential was calculated. Results The following average values of initial joint volume were recorded: group I -26.8 ml group II -43.7 ml and the control group -25.6 ml with significant differences: impingement vs. instability + laxity (p < 0.00001), impingement vs. instability without laxity (p = 0.0001). There was no significant difference between groups I and II. Joint volume was significantly reduced after labral repair (by average of 37 %, 13.8 ml, p < 0.0001). Capsular shift led to an even greater and more significant volume decrease (61 %, 26.7 ml, p < 0.001). Joint volume in the control group was reduced only by 11 %, 3.8 ml (p = 0.046).Conclusions Patients with unstable shoulders have enlarged joint volume as compared to patients with subacromial impingement. Arthroscopic techniques lead to a significant joint volume reduction, with the most powerful effect for capsular shift. Level of Evidence -Level 2.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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Effect of arthroscopic techniques on joint volume in shoulder instability: Bankart repair versus capsular shift

Lubiatowski

Długosz

Ślęzak

et al. 2016

International Orthopaedics (SICOT)

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“…39 Studies on cadavers have found that an excessively redundant capsule is one of the important reasons for symptomatic laxity in MDI. 40,41 We reported 55 (6%) shoulders that underwent arthroscopic laser-assisted capsulorrhaphy and 49 (6%) shoulders that underwent arthroscopic thermal shrinkage management. 13,34,42 Overall recurrence of instability for these patients was higher (22% and 24.5%, respectively); this is in accordance with results of other studies (45% to 60%).…”

Section: Recurrent Instabilitymentioning

confidence: 99%

“…Capsular volume reduction is proportional to the magnitude of capsular shift and the number of plications. 39,41,47 Surgical management should be individualized to address the anatomic cause of the instability. [48][49][50][51][52][53] Even if there is no pathognomonic finding, and in 98% of MDI there is no finding at all, capsular redundancy, increased glenohumeral volume and labral abnormalities can sometimes be found.…”

Section: Recurrent Instabilitymentioning

confidence: 99%