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The American Journal of Sports Medicine 31:247-252 (2003)
© 2003 American Orthopaedic Society for Sports Medicine

Anteromedial Capsular Redundancy and Labral Deficiency in Shoulder Instability

Christopher S. Ahmad, MD*, Michael Q. Freehill, MD, Theodore A. Blaine, MD, William N. Levine, MD and Louis U. Bigliani, MD

From the Center for Shoulder, Elbow, and Sports Medicine, Department of Orthopaedic Surgery, New York Orthopaedic Hospital, Columbia-Presbyterian Medical Center, New York, New York

* Address correspondence and reprint requests to Christopher S. Ahmad, MD, Center for Shoulder, Elbow, and Sports Medicine, Department of Orthopaedic Surgery, 622 West 168th Street, PH 11th Floor, New York, NY 10032

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.




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C. B. Dewing, F. McCormick, S. J. Bell, D. J. Solomon, M. Stanley, T. B. Rooney, and M. T. Provencher
An Analysis of Capsular Area in Patients With Anterior, Posterior, and Multidirectional Shoulder Instability
Am. J. Sports Med., March 1, 2008; 36(3): 515 - 522.
[Abstract] [Full Text] [PDF]


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