Arthroscopic glenohumeral capsular shift: Technical note and preliminary results

We have developed an arthroscopic technique to reinforce the torn inferior glenohumeral ligament and the elongated strained capsule, with no need for hardware implants: the arthroscopic capsuloplasty. We have assessed early results of arthroscopic capsuloplasty on seven active athletes, observed for a painful unstable shoulder. All cases presented with anterior inferior capsular distension and a strained or ruptured IGHL; these are indications for this technique, independent of the presence of a Bankart lesion. Cases where a Bankart lesion was also repaired were not considered in these preliminary results. As with an open standard Neer capsular shift, an arthroscopic capsular re-tightening is performed, by means of a shift of the anteroinferior capsule incised one centimeter from the glenoid rim. Results with an average follow-up of 12 months were appraised following the Walch-Duplay score. The global result was bad for one patient with a retractile capsulitis after 6 months and good for another at 13 months after surgery. The remaining five patients had excellent global results and have resumed sports at the same level as before. The authors consider this technique to be an alternative to thermal capsular shifts and open procedures, although the series is limited and follow-up short, yet with quite encouraging results. Level of evidence : Case Series (level IV).