• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.27-32
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• 2009

Purpose: We wanted to evaluate the effectiveness of inferior capsular plication for treating the anterior instability of the shoulder by comparing the prospective outcomes and the incidence of complications of the group (group1) that underwent arthroscopic vertical shift of the anteroinferior capsulo-labral complex and plication of the anterior band of inferior glenohumeral ligament and the group (group2) that underwent inferior capsular plication that was augmentated by the same method. Materials and Methods: From March 2005 to August 2007, we compared group 1 (42 cases) that underwent arthroscopic vertical shift of the anteroinferior capsulo-labral complex and plication of the anterior band of the inferior glenohumeral ligament and group 2 (33 cases) that underwent augmentated inferior capsular plication for recurrent anterior instability of the shoulder. The mean age was 22.5 years (range: 17~31 years) in group I, and 21.8 years (range: 16~30 years) in group II. The mean follow up was 23.5 months (range: 12~45 months in group I, and 20.1 months (range: 12~49 months) in group II. We checked the Rowe score and ROM preoperatively and at postoperative 6 months, 1 year and at the last follow up and we compared the incidence of complications. Results: The Rowe score increased from a preoperative mean of 20.6 to the last follow up mean of 86.8 after surgery in group I, and the Rowe score increased from a preoperative mean of 20.5 to the last follow up mean of 94.1 after surgery in group II. For the anterior instability of the shoulder, arthroscopic reconstruction had a good outcome in all of the cases, but group II had better outcomes and less complications than did group I (p<0.05). Conclusion: We thought that arthroscopic vertical shift of the anteroinferior capsulo-labral complex and plication of the anterior band of the inferior glenohumeral ligament with inferior capsular plication can lower the complication rate and show better outcomes.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.03a
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• pp.18-18
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• 2007

• Journal of Korean Orthopaedic Sports Medicine
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• v.4 no.1
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• pp.36-42
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• 2005

Purpose: To investigate the arthroscopic findings, and to evaluate the clinical outcomes of the treatment of posterior internal impingement of the shoulder in baseball players. Materials and Methods: We followed up 5 cases who were diagnosed as posterior internal impingement for the mean 15 months. All of the cases complained of the pain in the posterior shoulder at late cocking, and were positive in the relocation test added by hyper-horizontal abduction at $120^{\circ}$ abduction of the arm. We sutured posterior labral tear and SLAP lesion arthroscopically, and conducted debridement for rotator cuff. Three cases were performed of anterior capsular plication and the other two were performed of thermal capsular shrinkage. Pain, range of motion, and level of return to sports activity were assessed for the results. Results: As to the arthroscopic findings, all the five cases showed the fraying in posterosuperior labrum, and two of them was accompanied with the flap tear in posterosuperior labrum and the other one was accompanied with type 2 SLAP lesion. All the cases showed the fraying in supraspinatus, and one case showed partial tear. Meanwhile, in all the cases, the rotator cuff was impinged to the labrum at $90^{\circ}{\sim}120^{\circ}$ of abduction and external rotation. As to the postoperative results, all the cases did not complain of pain or instability while pitching, and the competition was recovered to be the mean 88%($80{\sim}100%$) of that before the injury. Conclusion: Definite diagnosis for the posterior internal impingement would be possible through arthroscopic examination. Favorable outcomes could be obtained with capsular plication or shrinkage for anterior microinstability and stretching exercise for posterior capsule tightness inducing the internal impingement.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.102-107
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• 2002

Purpose: The aim of this retrospective study were to report the short-term results of inferior capsular shift procedure using splitting subscapularis and capsule for the patients who had shoulder instability and were apt to recur after arthroscopic stabilization procedure. Materials & Methods : Fifteen cases of instability of the shoulder were included with an average follow-up of 2 years (range: 1$\~$3 years). There were 13 men and 2 women with an average age of 27years. Multidirectional instability was found in 4 cases, voluntary instability in 3 cases, bony Bankarte lesion in 2 cases and 6 cases were contact sportmen. Thirteen shoulders underwent the inferior capsular shifts and Bankart repairs and 2 shoulders without Bankart lesion underwent the inferior capsular shift only. Average 19 mm of shift (range: 10$\~$25 mm) was done. Results : Fourteen patients showed good and excellent results with one subluxation and one positive apprehension test. Postoperative ranges of motions did not change in forward elevation, external rotation at side and external rotation at 90$^{\circ}$ abduction (p>0.05). Conclusion : Inferior capsular shift procedure using splitting subscapularis and capsule can be helpful in shoulder instability patients who were high-risk group of recurrence with arthroscopic procedure.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.157-169
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• 1999

Eighty-nine shoulders in eighty-eight patients with traumatic unilateral anterior shoulder instability were evaluated for Rowe and UCLA scores, recurrence, return to activity, and range of motion by an independent examiner at an average of 39 months after either arthroscopic or open Bankart repair using suture anchors. The arthroscopic technique included a minimum of 3 anchors, and a routine incorporation of capsular plication and proximal shift. Twenty­six shoulders(86.6%) out of thirty in the open Bankart repair group had excellent or good results while fifty­four(91.5%) of the fifty-nine shoulders with arthroscopic Bankart repair had excellent or good results. The arthroscopic group revealed significantly better results in the Rowe(p=.041) and UCLA scores(p=.026). Two shoulders in each group developed redislocation. There were no significant differences in the loss of external rotation and return to prior activity between the two groups(p>.05). The residual instability occurred more frequently in the group of patients with lesser anchors. Arthroscopic suture anchor capsulorraphy has results equal to or better than the open Bankart procedure.