Arthroscopic capsulolabroplasty for posteroinferior multidirectional instability of the shoulder.
BACKGROUND
Arthroscopic treatment of posteroinferior multidirectional instability of the shoulder is not well documented.


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


METHODS
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.
Kim
Seung-Ho
SH
Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
Kim
Hyo-Kon
HK
Sun
Jong-I I
JI
Park
Jun-Sic
JS
Oh
Irvin
I
D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000601:surgery; D007593:Joint Instability / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D010147:Pain Measurement; D011446:Prospective Studies; D012785:Shoulder Joint / Q000601:surgery*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome