[Arthroscopic capsular shrinkage for posterosuperior internal impingement of the shoulder]

We evaluated clinical and radiological findings and functional results following arthroscopic capsular shrinkage in patients with internal impingement of the shoulder.

The study included four patients (2 females, 2 males; mean age 27.5 years; range 25 to 32 years) who underwent arthroscopic capsular shrinkage between 1997 and 2001. Three patients were overhead athletes (2 volleyball, 1 water polo player), the fourth was a clerk. All the patients suffered from shoulder pain upon abduction and external rotation and all received a preoperative unsuccessful rehabilitation for at least three months (range 3 to 10 months). Following arthroscopic examination of the glenohumeral joint, anterior joint capsule was shrunk using a radiofrequency probe. A specific rehabilitation program was applied postoperatively. The mean follow-up was 3.5 years (range 2 to 6 years).

The Neer test was positive in all cases, and the relocation test in 3 cases, preoperatively. Magnetic resonance imaging showed contact between the glenoid rim and the greater tuberosity in three cases, degeneration in the rotator cuff in two cases, a partial tear in one patient, and a subchondral cyst in another. Arthroscopic examination revealed glenoid-rotator cuff contact in all cases and degeneration in the contact areas. Drive-through sign was positive in all cases. Kissing lesion was present in one case. No SLAP lesion was identified. The patients' complaints disappeared and the three athletes were able to resume their professional sporting activities.

Arthroscopic shrinkage of the stretched anterior capsule proved successful throughout a follow-up period of at least two years.