Anterior Capsular Reconstruction With Dermal Allograft Augmentation for Multidirectional Shoulder Instability

Multidirectional shoulder instability, particularly in patients with underlying connective tissue disorders poses a surgical challenge. After exhaustive nonoperative treatment, surgical intervention is focused on restoration of the anterior and inferior capsular restraints. Oftentimes, after longstanding recurrent instability, the anterior capsule is diminutive with diffuse scarring and adhesions, requiring meticulous surgical dissection and allograft augmentation. Although outcome data are sparse, dermal allograft augmentation offers enhanced structure to the glenoid and humerus, and variable thickness for surgical management. The purpose of this surgical technique is to describe a procedure for open anterior and inferior capsular reconstruction using dermal allograft augmentation in revision anterior shoulder stabilization for a patient with Ehlers-Danlos syndrome, with recurrent multidirectional instability.