Retrospective review of 25 patients treated with arthroscopic transglenoid capsular shift for multidirectional instability of the shoulder. All had failed at least 3 months of physical therapy. The question: does arthroscopic capsular shift hold up over long-term follow-up the way open shift does?
When an MDI patient fails a dedicated rehab program, the surgical target is the same regardless of subtype: the incompetent inferior glenohumeral ligament complex. This paper's value is duration. Open capsular shift was known to erode over time (Hawkins reported 39% failure at 3 to 5 years), so a short-term arthroscopic success meant little.
At an average 60 months, the 12% recurrence held up next to open series, which is why the authors frame arthroscopic shift as a durable option, not just a less invasive one. The practical mental model for failures: 2 of 3 recurrences had a traumatic labral avulsion. In an active patient, laxity plus a traumatic tear means you address both, or you fail.
Remember the technical pitfalls the authors name: inadequate inferior release, too few sutures, and failing to tie the knot posteriorly over the infraspinatus fascia. On the transglenoid drill, aim the Beath pin at the inferomedial scapular angle to protect the suprascapular nerve.
Retrospective review of 25 patients treated with arthroscopic transglenoid capsular shift for multidirectional instability of the shoulder. All had failed at least 3 months of physical therapy. The question: does arthroscopic capsular shift hold up over long-term follow-up the way open shift does?
When an MDI patient fails a dedicated rehab program, the surgical target is the same regardless of subtype: the incompetent inferior glenohumeral ligament complex. This paper's value is duration. Open capsular shift was known to erode over time (Hawkins reported 39% failure at 3 to 5 years), so a short-term arthroscopic success meant little.
At an average 60 months, the 12% recurrence held up next to open series, which is why the authors frame arthroscopic shift as a durable option, not just a less invasive one. The practical mental model for failures: 2 of 3 recurrences had a traumatic labral avulsion. In an active patient, laxity plus a traumatic tear means you address both, or you fail.
Remember the technical pitfalls the authors name: inadequate inferior release, too few sutures, and failing to tie the knot posteriorly over the infraspinatus fascia. On the transglenoid drill, aim the Beath pin at the inferomedial scapular angle to protect the suprascapular nerve.