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This Article Full Text Full Text (PDF) All Versions of this Article: 32/3/594    most recent 0363546503262170v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (8) Citing Articles via Google Scholar Google Scholar Articles by Kim, S.-H. Articles by Oh, I. Search for Related Content PubMed PubMed Citation Articles by Kim, S.-H. Articles by Oh, I. Related Collections Shoulder Arthroscopy

Arthroscopic Capsulolabroplasty for Posteroinferior Multidirectional Instability of the Shoulder

From the Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea

^* Address correspondence to Seung-Ho Kim, MD, Department of Orthopaedic Surgery, Samsung Medical Center, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.

Background: Arthroscopic treatment of posteroinferior multidirectional instability of the shoulder is not well documented.

Purpose: To evaluate pathologic lesions of posteroinferior multidirectional instability and the results of arthroscopic capsulolabroplasty.

Study Design: Prospective nonrandomized clinical trial.

Methods: Thirty-one patients with posteroinferior multidirectional instability were prospectively evaluated after arthroscopic capsulolabroplasty (mean follow-up, 51 months). Labral lesion and height were measured in the MRI arthrogram and arthroscopic examination.

Results: All patients had a labral lesion and variable capsular stretching in the posteroinferior aspect. There were 11 type I labral lesions (incomplete detachment), 12 type II (the Kim’s lesion: incomplete and concealed avulsion), 6 type III (chondrolabral erosion), and 2 type IV (flap tear). All patients with type II and III lesions had chondrolabral retroversion, with lost labral height in the MRI arthrogram and arthroscopic examination. Twenty-one patients had an excellent Rowe score, nine had good scores, and one had a fair score. Thirty patients had stable shoulders, and one had recurrent instability. All patients had improved shoulder scores and function and pain scores.

Conclusions: Symptomatic patients with posteroinferior multidirectional instability had posteroinferior labral lesions, including retroversion of the posteroinferior labrum, which were previously unrecognized. Restoration of the labral buttress and capsular tension by arthroscopic capsulolabroplasty successfully stabilized shoulders with posteroinferior multidirectional instability.

Key Words: multidirectional instability • arthroscopy • capsulolabroplasty • outcome • shoulder

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