title: Improved range of motion after medial-based T capsular shift for recurrent post-traumatic anterior shoulder dislocation.
abstract: Postoperative function and recurrence rates are reportedly similar following open and arthroscopic procedures for recurrent anterior instability of the shoulder. However, various studies have reported greater restriction of shoulder mobility with open stabilisation. Sixty-two patients with post-traumatic recurrent anterior instability of the shoulder underwent anatomic reconstruction of the capsular-labral complex using a medial-based T capsular shift. They were investigated preoperatively and 53 of them were reexamined at an average of 41.5 months after operation. Function and stability improved: the Rowe score increased from 33.2 to 80.6, the Constant score from 81.5 to 89.8 points. Pre- and post-operative mobility of the affected shoulder was reduced in all planes of movement compared to the contralateral side. Passive mobility did not deteriorate in any direction with surgery. Passive adduction, forward flexion and external rotation in 90 degrees abduction of the arm improved significantly and active mobility rose to the values of the contralateral side. The restriction of mobility noted postoperatively thus appears as a consequence of the underlying pathology rather than of the surgical procedure. The recurrence rate after primary stabilisation was 1.6%. Based on these findings, the medial-based T capsular shift remains an appropriate surgical option in the treatment of chronic post-traumatic anterior instability of the shoulder.
authors.affiliation: Orthopaedic Department, Marienstift Hospital, Arnstadt, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Ziegert
authors.forename: Ina
authors.initials: I
authors.lastname: Ziegert
authors.forename: Ulrich
authors.initials: U
authors.lastname: Irlenbusch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000601:surgery*; D007593:Joint Instability / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D016059:Range of Motion, Articular; D012008:Recurrence; D012783:Shoulder Dislocation / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult