title: Arthroscopic posterior-inferior capsular release in the treatment of overhead athletes.
abstract: In this article, we present our technique for arthroscopic posterior-inferior capsular release and report the results of applying this technique in a population of athletes with symptomatic glenohumeral internal rotation deficit (GIRD) that was unresponsive to nonoperative treatment and was preventing them from returning to sport. Fifteen overhead athletes met the inclusion criteria. Two were lost to follow-up. Of the 13 remaining, 6 underwent isolated posterior-inferior capsular releases, and 7 had concomitant procedures. Before and after surgery, patients completed an activity questionnaire, which included the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form. Passive internal rotation in the scapular plane was measured with a bubble goniometer. Mean age was 21 years (range, 16-33 years). Mean follow-up was 31.1 months (range, 24-59 months). Mean ASES score improved significantly (P<.01) from before surgery (71.5) to after surgery (86.9). Mean GIRD improved from 43.1° to 9.7° (P<.05). Three athletes (23%) did not return to their preoperative level of play; the other 10 (77%) returned to their same level of play or a higher level. Selective arthroscopic posterior-inferior capsular release may be a reasonable solution for overhead athletes with symptomatic GIRD unresponsive to conservative management.
authors.forename: Jason
authors.initials: J
authors.lastname: Codding
authors.forename: Diane L
authors.initials: DL
authors.lastname: Dahm
authors.forename: L Pearce
authors.initials: LP
authors.lastname: McCarty
authors.forename: Jedediah H
authors.initials: JH
authors.lastname: May
authors.forename: Lanning H
authors.initials: LH
authors.lastname: Tucker
authors.affiliation: Sports and Orthopaedic Specialists, Edina, MN. daniel.buss@allina.com.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Buss
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D001265:Athletic Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D057913:Joint Capsule Release; D007592:Joint Diseases / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D016059:Range of Motion, Articular; D020127:Recovery of Function; D000068958:Return to Sport; D012399:Rotation; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D055815:Young Adult