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Open Capsulorrhaphy for Recurrent Multidirectional Instability of the Shoulder.

Ioanna K Bolia1, Rebecca Griffith1, Nickolas Fretes1

  • 1USC Epstein Family Center for Sports Medicine, Keck Medicine of USC, Los Angeles, California, USA.

Video Journal of Sports Medicine
|May 1, 2025
PubMed
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Open capsulorrhaphy effectively stabilizes shoulders with multidirectional instability (MDI), especially after failed arthroscopic procedures. This surgical technique helps athletes return to sport with a high success rate and low recurrence of instability.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Shoulder Instability

Background:

  • Multidirectional instability (MDI) of the shoulder presents management challenges, particularly in athletes requiring revision surgeries.
  • Both open and arthroscopic surgical approaches exist for shoulder MDI management.

Purpose of the Study:

  • To describe the technique and outcomes of open capsulorrhaphy for shoulder multidirectional instability.
  • To evaluate the efficacy of open capsulorrhaphy in athletes with tissue hyperlaxity and previous failed stabilization.

Main Methods:

  • Open capsulorrhaphy via a deltopectoral approach.
  • Subscapularis tenotomy, capsulotomy, and capsular repair with suture anchors.
  • Augmentation with transosseous equivalent repair of the subscapularis tendon.
Keywords:
MDIcapsular shiftcapsulorrhaphyinstabilityrecurrentshoulder

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Main Results:

  • Successful shoulder stabilization was achieved in a young female athlete with hyperlaxity and prior failed arthroscopic surgery.
  • The athlete returned to sport at 6 months postoperatively with no recurrent instability episodes.
  • Literature suggests 82%-97% success rates for open capsulorrhaphy in preventing recurrent MDI episodes.

Conclusions:

  • Open capsulorrhaphy is a viable option for managing shoulder MDI, particularly in cases of tissue hyperlaxity and failed prior arthroscopic stabilization.
  • Further research is needed to define optimal indications and outcomes for physically active patients, including those with connective tissue disorders.