Short-term effectiveness of arthroscopically capsular vertical mattress suturing for shoulder recurrent anterior dislocation combined with joint laxity_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Yan , MA Lin ^Δ , YANG Mingyu , MU Miduo , YANG Aining ,  ZHOU Binghua ,  TANG Kanglai

Sports Medicine Center, the First Affiliated Hospital, Army Military Medical University, Chongqing, 400038, P.R.China;

Corresponding author：

ZHOU Binghua, Email: yijian510868@hotmail.com; TANG Kanglai, Email: tangkanglai@hotmail.com

Keywords：

Mattress suture; capsule; shoulder; recurrent anterior dislocation; joint laxity

DOI：

10.7507/1002-1892.202005030

Video：

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Objective To evaluate the short-term effectiveness of arthroscopically capsular vertical mattress suturing for shoulder recurrent anterior dislocation combined with joint laxity.Methods A retrospective analysis was performed on 6 shoulder recurrent anterior dislocation patients combined with joint laxity treated with arthroscopically capsular vertical mattress suturing between January 2017 and December 2018. There were 5 males and 1 female with an average age of 20.8 years (range, 19-24 years). The number of shoulder dislocation was 3-18 times, with an average of 9.5 times. The disease duration ranged from 2 to 60 months, with an average of 25.3 months. The preoperative Beighton score was 4-7, with an average of 5.8; the Instability Severity Index Score (ISIS) was 2-5, with an average of 3.5. There were 5 cases of simple Bankart injury and 1 case of bony Bankart injury. The range of motion of shoulder joint (including active flexion and lifting, external rotation, abduction and external rotation, and internal ratation) was recorded before operation and at last follow-up; Oxford shoulder instability score, Rowe shoulder instability score, and Simple Shoulder Test (SST) score were used to evaluate shoulder joint function before operation, at 6 months after operation, and at last follow-up, and complications were recorded.Results All patients were followed up 16-28 months (mean, 19.3 months). During the follow-up, all patients had satisfactory motor function, and no re-dislocation and postoperative neurovascular complications occurred. At last follow-up, the activities of active external rotation and abduction and external rotation were significantly improved when compared with those before operation (P<0.05); the activities of active flexion and lifting and internal rotation were not limited before and after operation, and the difference was not significant (P>0.05). The Oxford shoulder instability score, Rowe shoulder instability score, and SST score at 6 months after operation and at last follow-up were significantly improved when compared with those before operation (P<0.05); there was no significant difference between at 6 months after operation and at last follow-up (P>0.05).Conclusion The treatment of shoulder recurrent anterior dislocation combined with joint laxity by arthroscopically vertical matress suturing can achieve good short-term effectiveness.

Citation： LI Yan, MA Lin, YANG Mingyu, MU Miduo, YANG Aining, ZHOU Binghua, TANG Kanglai. Short-term effectiveness of arthroscopically capsular vertical mattress suturing for shoulder recurrent anterior dislocation combined with joint laxity. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(11): 1392-1398. doi: 10.7507/1002-1892.202005030 Copy

1.	Rees JL, Shah A, Edwards K, et al. Treatment of first-time traumatic anterior shoulder dislocation: the UK TASH-D cohort study. Health Technol Assess, 2019, 23(18): 1-104.
2.	Dickens JF, Slaven SE, Cameron KL, et al. Prospective evaluation of glenoid bone loss after first-time and recurrent anterior glenohumeral instability events. Am J Sports Med, 2019, 47(5): 1082-1089.
3.	Lee SH, Lim KH, Kim JW. Risk factors for recurrence of anterior-inferior instability of the shoulder after arthroscopic bankart repair in patients younger than 30 years. Arthroscopy, 2018, 34(9): 2530-2536.
4.	Vermeulen AE, Landman EBM, Veen EJD, et al. Long-term clinical outcome of arthroscopic Bankart repair with suture anchors. J Shoulder Elbow Surg, 2019, 28(5): e137-e143.
5.	Kennedy MI, Murphy C, Dornan GJ, et al. Variability of reporting recurrence after arthroscopic bankart repair: A call for a standardized study design. Orthop J Sports Med, 2019, 7(5): 2325967119846915. doi: 10.1177/2325967119846915.eCollection2019May.
6.	Johnson SM, Robinson CM. Shoulder instability in patients with joint hyperlaxity. J Bone Joint Surg Am, 2010, 92(6): 1545-1557.
7.	Su F, Kowalczuk M, Ikpe S, et al. Risk factors for failure of arthroscopic revision anterior shoulder stabilization. J Bone Joint Surg (Am), 2018, 100(15): 1319-1325.
8.	Park JY, Chung SW, Kumar G, et al. Factors affecting capsular volume changes and association with outcomes after Bankart repair and capsular shift. Am J Sports Med, 2015, 43(2): 428-438.
9.	Lundberg BJ. The frozen shoulder. Clinical and radiographical observations. The effect of manipulation under general anesthesia. Structure and glycosaminoglycan content of the joint capsule. Local bone metabolism. Acta Orthop Scand Suppl, 1969, 119: 1-59.
10.	Ng AW, Chu CM, Lo WN, et al. Assessment of capsular laxity in patients with recurrent anterior shoulder dislocation using MRI. AJR Am J Roentgenol, 2009, 192(6): 1690-1695.
11.	Dewing CB, McCormick F, Bell SJ, et al. An analysis of capsular area in patients with anterior, posterior, and multidirectional shoulder instability. Am J Sports Med, 2008, 36(3): 515-522.
12.	Koyonos L, Kraeutler MJ, O’Brien DF, et al. A prospective cohort study investigating the effect of generalized joint hypermobility on outcomes after arthroscopic anterior shoulder stabilization. Phys Sportsmed, 2016, 44(4): 380-384.
13.	Balg F, Boileau P. The instability severity index score. A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation. J Bone Joint Surg (Br), 2007, 89(11): 1470-1477.
14.	Mihata T, Lee TQ, Hasegawa A, et al. Superior capsule reconstruction for reinforcement of arthroscopic rotator cuff repair improves cuff integrity. Am J Sports Med, 2019, 47(2): 379-388.
15.	Raman J, MacDermid JC, Walton D, et al. Rasch analysis indicates that the Simple Shoulder Test is robust, but minor item modifications and attention to gender differences should be considered. J Hand Ther, 2017, 30(3): 348-358.
16.	Saccomanno MF, Fodale M, Capasso L, et al. Generalized joint laxity and multidirectional instability of the shoulder. Joints, 2014, 1(4): 171-179.
17.	Wilson WR, Magnussen RA, Irribarra LA, et al. Variability of the capsular anatomy in the rotator interval region of the shoulder. J Shoulder Elbow Surg, 2013, 22(6): 856-861.
18.	Murena L, Guindani N, Turino S, et al. Long-term outcome of Rockwood capsular shift for recurrent shoulder dislocation. J Orthop Surg (Hong Kong), 2016, 24(3): 392-397.
19.	Levy DM, Gvozdyev BV, Schulz BM, et al. Arthroscopic anterior shoulder stabilization with percutaneous assistance and posteroinferior capsular plication. Am J Orthop (Belle Mead NJ), 2014, 43(8): 364-369.
20.	Lino W, Belangero WD. Labrum repair combined with arthroscopic reduction of capsular volume in shoulder instability. Int Orthop, 2006, 30(4): 219-223.
21.	Kim DW, Kim CK, Jung SW. An arthroscopic pleated capsular shift for recurrent anterior dislocation of the shoulder. Knee Surg Sports Traumatol Arthrosc, 2012, 20(12): 2579-2584.
22.	Gaskill TR, Taylor DC, Millett PJ. Management of multidirectional instability of the shoulder. J Am Acad Orthop Surg, 2011, 19(12): 758-767.
23.	Burt DM. Arthroscopic repair of inferior labrum from anterior to posterior lesions associated with multidirectional instability of the shoulder. Arthrosc Tech, 2014, 3(6): e727-730.
24.	Cohen SB, Wiley W, Goradia VK, et al. Anterior capsulorrhaphy: an in vitro comparison of volume reduction—arthroscopic plication versus open capsular shift. Arthroscopy, 2005, 21(6): 659-664.
25.	Gulotta LV, Lobatto D, Delos D, et al. Anterior shoulder capsular tears in professional baseball players. J Shoulder Elbow Surg, 2014, 23(8): e173-178.
26.	Neer 2nd CN, Foster CR. Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder. A preliminary report. J Bone Joint Surg (Am), 1980, 62(6): 897-908.
27.	Ro K, Kim MS, Kim JD, et al. Arthroscopic findings and clinical outcomes in patients 40 years of age and older with recurrent shoulder dislocation. Arthroscopy, 2019, 35(2): 314-322.
28.	Gervasi E, Sebastiani E, Spicuzza A. Multidirectional Shoulder Instability: Arthroscopic labral augmentation. Arthrosc Tech, 2017, 6(1): e219-e225.
29.	Kraszewski AP, Mayer SW, Kontaxis A, et al. Mapping glenohumeral laxity: effect of capsule tension and abduction in cadaveric shoulders. J Shoulder Elbow Surg, 2018, 27(4): 624-634.

1. Rees JL, Shah A, Edwards K, et al. Treatment of first-time traumatic anterior shoulder dislocation: the UK TASH-D cohort study. Health Technol Assess, 2019, 23(18): 1-104.
2. Dickens JF, Slaven SE, Cameron KL, et al. Prospective evaluation of glenoid bone loss after first-time and recurrent anterior glenohumeral instability events. Am J Sports Med, 2019, 47(5): 1082-1089.
3. Lee SH, Lim KH, Kim JW. Risk factors for recurrence of anterior-inferior instability of the shoulder after arthroscopic bankart repair in patients younger than 30 years. Arthroscopy, 2018, 34(9): 2530-2536.
4. Vermeulen AE, Landman EBM, Veen EJD, et al. Long-term clinical outcome of arthroscopic Bankart repair with suture anchors. J Shoulder Elbow Surg, 2019, 28(5): e137-e143.
5. Kennedy MI, Murphy C, Dornan GJ, et al. Variability of reporting recurrence after arthroscopic bankart repair: A call for a standardized study design. Orthop J Sports Med, 2019, 7(5): 2325967119846915. doi: 10.1177/2325967119846915.eCollection2019May.
6. Johnson SM, Robinson CM. Shoulder instability in patients with joint hyperlaxity. J Bone Joint Surg Am, 2010, 92(6): 1545-1557.
7. Su F, Kowalczuk M, Ikpe S, et al. Risk factors for failure of arthroscopic revision anterior shoulder stabilization. J Bone Joint Surg (Am), 2018, 100(15): 1319-1325.
8. Park JY, Chung SW, Kumar G, et al. Factors affecting capsular volume changes and association with outcomes after Bankart repair and capsular shift. Am J Sports Med, 2015, 43(2): 428-438.
9. Lundberg BJ. The frozen shoulder. Clinical and radiographical observations. The effect of manipulation under general anesthesia. Structure and glycosaminoglycan content of the joint capsule. Local bone metabolism. Acta Orthop Scand Suppl, 1969, 119: 1-59.
10. Ng AW, Chu CM, Lo WN, et al. Assessment of capsular laxity in patients with recurrent anterior shoulder dislocation using MRI. AJR Am J Roentgenol, 2009, 192(6): 1690-1695.
11. Dewing CB, McCormick F, Bell SJ, et al. An analysis of capsular area in patients with anterior, posterior, and multidirectional shoulder instability. Am J Sports Med, 2008, 36(3): 515-522.
12. Koyonos L, Kraeutler MJ, O’Brien DF, et al. A prospective cohort study investigating the effect of generalized joint hypermobility on outcomes after arthroscopic anterior shoulder stabilization. Phys Sportsmed, 2016, 44(4): 380-384.
13. Balg F, Boileau P. The instability severity index score. A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation. J Bone Joint Surg (Br), 2007, 89(11): 1470-1477.
14. Mihata T, Lee TQ, Hasegawa A, et al. Superior capsule reconstruction for reinforcement of arthroscopic rotator cuff repair improves cuff integrity. Am J Sports Med, 2019, 47(2): 379-388.
15. Raman J, MacDermid JC, Walton D, et al. Rasch analysis indicates that the Simple Shoulder Test is robust, but minor item modifications and attention to gender differences should be considered. J Hand Ther, 2017, 30(3): 348-358.
16. Saccomanno MF, Fodale M, Capasso L, et al. Generalized joint laxity and multidirectional instability of the shoulder. Joints, 2014, 1(4): 171-179.
17. Wilson WR, Magnussen RA, Irribarra LA, et al. Variability of the capsular anatomy in the rotator interval region of the shoulder. J Shoulder Elbow Surg, 2013, 22(6): 856-861.
18. Murena L, Guindani N, Turino S, et al. Long-term outcome of Rockwood capsular shift for recurrent shoulder dislocation. J Orthop Surg (Hong Kong), 2016, 24(3): 392-397.
19. Levy DM, Gvozdyev BV, Schulz BM, et al. Arthroscopic anterior shoulder stabilization with percutaneous assistance and posteroinferior capsular plication. Am J Orthop (Belle Mead NJ), 2014, 43(8): 364-369.
20. Lino W, Belangero WD. Labrum repair combined with arthroscopic reduction of capsular volume in shoulder instability. Int Orthop, 2006, 30(4): 219-223.
21. Kim DW, Kim CK, Jung SW. An arthroscopic pleated capsular shift for recurrent anterior dislocation of the shoulder. Knee Surg Sports Traumatol Arthrosc, 2012, 20(12): 2579-2584.
22. Gaskill TR, Taylor DC, Millett PJ. Management of multidirectional instability of the shoulder. J Am Acad Orthop Surg, 2011, 19(12): 758-767.
23. Burt DM. Arthroscopic repair of inferior labrum from anterior to posterior lesions associated with multidirectional instability of the shoulder. Arthrosc Tech, 2014, 3(6): e727-730.
24. Cohen SB, Wiley W, Goradia VK, et al. Anterior capsulorrhaphy: an in vitro comparison of volume reduction—arthroscopic plication versus open capsular shift. Arthroscopy, 2005, 21(6): 659-664.
25. Gulotta LV, Lobatto D, Delos D, et al. Anterior shoulder capsular tears in professional baseball players. J Shoulder Elbow Surg, 2014, 23(8): e173-178.
26. Neer 2nd CN, Foster CR. Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder. A preliminary report. J Bone Joint Surg (Am), 1980, 62(6): 897-908.
27. Ro K, Kim MS, Kim JD, et al. Arthroscopic findings and clinical outcomes in patients 40 years of age and older with recurrent shoulder dislocation. Arthroscopy, 2019, 35(2): 314-322.
28. Gervasi E, Sebastiani E, Spicuzza A. Multidirectional Shoulder Instability: Arthroscopic labral augmentation. Arthrosc Tech, 2017, 6(1): e219-e225.
29. Kraszewski AP, Mayer SW, Kontaxis A, et al. Mapping glenohumeral laxity: effect of capsule tension and abduction in cadaveric shoulders. J Shoulder Elbow Surg, 2018, 27(4): 624-634.

Chinese Journal of Reparative and Reconstructive Surgery

Short-term effectiveness of arthroscopically capsular vertical mattress suturing for shoulder recurrent anterior dislocation combined with joint laxity

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