title: Effect of arthroscopic techniques on joint volume in shoulder instability: Bankart repair versus capsular shift.
abstract: The evaluation of glenohumeral joint volume in both unstable (with/without laxity) and stable shoulders (subacromial impingement) and volume reduction potential of arthroscopic techniques: (labral anchor repair vs. capsular shift).
  
  
  
  Material was based on 133 patients: anterior shoulder instability without laxity (group I, n = 49), with laxity (group II, n = 22) and subacromial impingement (control group, n = 62) operated in 2010-2011. Group I received arthroscopic Bankart repair, group; II - arthroscopic anterior capsular plication, control group - subacromial decompression. Joint volume was measured by fluid aspiration into the syringe via arthroscope, before and after procedure. Then volume reduction potential was calculated.
  
  
  
  The following average values of initial joint volume were recorded: group I - 26.8 ml group II - 43.7 ml and the control group - 25.6 ml with significant differences: impingement vs. instability + laxity (p < 0.00001), impingement vs. instability without laxity (p = 0.0001). There was no significant difference between groups I and II. Joint volume was significantly reduced after labral repair (by average of 37 %, 13.8 ml, p < 0.0001). Capsular shift led to an even greater and more significant volume decrease (61 %, 26.7 ml, p < 0.001). Joint volume in the control group was reduced only by 11 %, 3.8 ml (p = 0.046).
  
  
  
  Patients with unstable shoulders have enlarged joint volume as compared to patients with subacromial impingement. Arthroscopic techniques lead to a significant joint volume reduction, with the most powerful effect for capsular shift. Level of Evidence - Level 2.
authors.affiliation: Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences in Poznan, Poznań, Poland.|Rehasport Clinic, Poznań, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Lubiatowski
authors.affiliation: Rehasport Clinic, Poznań, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Długosz
authors.affiliation: Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences in Poznan, Poznań, Poland.|Rehasport Clinic, Poznań, Poland.
authors.forename: Marta
authors.initials: M
authors.lastname: Ślęzak
authors.affiliation: Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences in Poznan, Poznań, Poland.|Rehasport Clinic, Poznań, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Ogrodowicz
authors.affiliation: Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences in Poznan, Poznań, Poland. przemyslaw.lubiatowski@rehasport.pl.|Rehasport Clinic, Poznań, Poland. przemyslaw.lubiatowski@rehasport.pl.
authors.forename: Jakub
authors.initials: J
authors.lastname: Stefaniak
authors.affiliation: Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences in Poznan, Poznań, Poland.|Rehasport Clinic, Poznań, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Walecka
authors.affiliation: Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences in Poznan, Poznań, Poland.
authors.forename: Leszek
authors.initials: L
authors.lastname: Romanowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
keywords: Bankart repair; Capsular shift; Joint volume; Shoulder arthroscopy; Shoulder instability