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Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
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2007, Number 2

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Acta Ortop Mex 2007; 21 (2)

Capsular retensioning in anterior unidirectional glenohumeral instability

Benítez PL, Martínez MO, Castañeda LE
Full text How to cite this article

Language: Spanish
References: 12
Page: 69-76
PDF size: 175.46 Kb.


Key words:

instability, shoulder, arthroplasty.

ABSTRACT

Objective. To present the experience of the Orthopedics Service PEMEX South Central Hospital in the management of anterior unidirectional shoulder instability with an arthroscopic technique consisting of capsular retensioning either combined with other anatomical repair procedures or alone. Material and methods. Thirty-one patients with anterior unidirectional shoulder instability operated-on between January 1999 and December 2005 were included. Fourteen patients underwent capsular retensioning and radiofrequency, and in 17 patients, capsular retensioning was combined with suture anchors. Patients with a history of relapsing glenohumeral dislocations and subluxations, with anterior instability, with or without associated Bankart lesions were selected; all of them were young. Results. The results were assessed considering basically the occurrence of instability during the postoperative follow-up. No cases of recurring instability occurred. Two cases had neuroma and one experienced irritation of the suture site. Six patients had residual limitation of combined lateral rotation and abduction movements, of a mean of 10° compared with the healthy contralateral side. The most frequent incident was the leak of solutions to the soft tissues. Conclusions. Capsular retensioning, whether combined or not with other anatomical repair techniques, has proven to result in a highly satisfactory rate of glenohumeral stabilization in cases of anterior unidirectional instabilities. The arthroscopic approach offers the well-known advantages of causing less damage to the soft tissues, and a shorter time to starting rehabilitation therapy and exercises.


REFERENCES

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  2. Canale TS, Azar M, Beaty J: Anterior glenohumeral instability. Campbell´s Operative Orthopaedics. 10a ed, Mosby editorial, USA 2003; 2: 2226-41.

  3. Andrews JR, Timmerman LA: Artroscopía. 1ª edición. Marban editoriales. Madrid 2001: 105-13.

  4. Hewitt M, Getelman H, Zinder J: Arthroscopic management of shoulder Instability: pancapsular plication. Orthop Clinics of North America 2003; 34(4): 264-72.

  5. Stokes A, Savoie H, Field D, Ramsey R: Arthroscopic repair of anterior glenohumeral instability and rotator interval lesions. Orthop Clinics of North America 2003; 34(5): 318-26.

  6. Freedman KB, Smith AP, Romeo AA: Open Bankart repair versus arthroscopic repair with transglenoid sutures or bioabsorbable tacks for recurrent Anterior instability of the shoulder: a meta-analysis. Am J Sports Med 2004; 32(6): 1520-7.

  7. Fleega BA: Arthroscopic reinforced capsular shift of anterior shoulder instability. Arthroscopy 2004; 20(5): 543-6.

  8. Chroustovsky J, Malusek P, Jircik M: Treatment of anterior glenohumeral instability: personal experience with an arthroscopic stabilization technique, its indications and results. Acta Chir Traumatol Cech 2003; 70(3): 164-9.

  9. Rhee YG, Lee DH, Chun IH, Bae SC: Glenohumeral arthropathy after arthroscopic anterior shoulder stabilization. Arthroscopy 2004; 20(4): 402-6.

  10. Rumack MD, Wilson R, Charboneau W: Diagnóstico por Ecografía. 2ª edición. Marban editoriales. Madrid 2001: 844-51.

  11. Fu FH: Future trends in thermal energy. Clinics in Sports Medicine 2002; 2(4).

  12. Stokes DA: Arthroscopic repair of anterior glenohumeral instability and rotator interval lesions. Orthopedic Clinics of North America 2003; 34(4).




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Acta Ortop Mex. 2007 Mar-Abr;21