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Arthroscopic stabilization for atraumatic shoulder instability: minimum two-year outcomes.

James Dalrymple1, David Butt1, William Rudge1

  • 1Royal National Orthopaedic Hospital, Middlesex, UK.

JSES International
|April 24, 2026
PubMed
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Arthroscopic inferior capsular shift improved shoulder function and reduced pain for atraumatic instability. However, recurrence rates were high, particularly in younger females, necessitating careful patient selection and counseling.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Shoulder Instability Research

Background:

  • Atraumatic shoulder instability (type II glenohumeral instability) presents management challenges with limited surgical evidence.
  • This study focuses on arthroscopic inferior capsular shift outcomes for type II instability.

Purpose of the Study:

  • To evaluate the effectiveness and recurrence rates of arthroscopic inferior capsular shift for atraumatic type II shoulder instability.
  • To identify predictors of recurrence following this surgical procedure.

Main Methods:

  • Retrospective analysis of 72 shoulders in 70 patients undergoing arthroscopic inferior capsular shift (2013-2017).
  • Inclusion criteria: atraumatic recurrent instability, minimum 2-year follow-up; exclusion: traumatic/structural instability.
Keywords:
ArthroscopyAtraumatic instabilityCapsular shiftInstabilityShoulderSurgery

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  • Analysis of pre- and post-operative outcomes, recurrence rates, and recurrence predictors.

    • Main Results:

    • Significant improvements in pain scores, shoulder function (Stanmore PONS), and quality of life (Oxford Shoulder Score).
    • A 39% recurrence rate of instability was observed, with 8.5% requiring revision surgery.
    • Recurrence was more prevalent in females and patients under 30; hypermobility was not a predictor.

    Conclusions:

    • Arthroscopic inferior capsular shift offers functional and pain benefits for recalcitrant type II instability.
    • High recurrence rates necessitate patient-specific surgical decisions and thorough pre-operative counseling, especially for younger females.
    • Younger age and female gender are identified as significant predictors of recurrence.