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Effects of capsular plication and rotator interval closure in simulated multidirectional shoulder instability
Brian L Shafer1, Teruhisa Mihata, Michelle H McGarry
1University of Southern California, Orthopaedic Surgery Associates, 1510 San Pablo Street, Suite 322, Los Angeles, CA 90033, USA.
The Journal of Bone and Joint Surgery. American Volume
|January 4, 2008
Summary
This study biomechanically assessed arthroscopic shoulder instability repair. Capsular plication alone restored range of motion, while rotator interval closure reduced glenohumeral translation, potentially preventing overtightening.
Area of Science:
- Orthopedic Surgery
- Biomechanical Analysis
- Shoulder Instability
Background:
- Arthroscopic capsular plication and rotator interval closure are used for multidirectional shoulder instability.
- Previous studies show clinical effectiveness, but biomechanical effects remain unclear.
Purpose of the Study:
- To biomechanically evaluate the impact of arthroscopic capsular plication with rotator interval closure.
- Assess effects on rotational range of motion, humeral head position, and glenohumeral translation.
Main Methods:
- Seven cadaveric shoulders were tested in intact, stretched, and post-repair states (anterior plication, posterior plication, rotator interval closure).
- Measurements included rotational range of motion and glenohumeral translations under load (15-N and 20-N).
- Testing was performed at 60 and 0 degrees of glenohumeral abduction.
Main Results:
- Stretching increased rotational range of motion.
- Anterior plication restored rotation to intact levels.
- Rotator interval closure, combined with plication, significantly reduced glenohumeral translation in specific positions, with potential for overtightening.
Conclusions:
- Capsular plication alone normalizes range of motion.
- Rotator interval closure is crucial for reducing translation.
- Repair outcomes are position-dependent, and overtightening is a risk with added closure.
