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Arthroscopic Capsular Plication Shows Low Failure Rates and Meaningful Functional Improvement in Multidirectional
Chandler M Catanzaro1, Caleb W Rogers1, Joseph A Q Karam1
1Department of Orthopaedics and Physical Medicine Medical University of South Carolina Charleston South Carolina U.S.A.
Purpose:
To evaluate clinical outcomes and failure rates after arthroscopic capsular plication for multidirectional shoulder instability in patients with and without hypermobile Ehlers-Danlos syndrome.
Methods:
A retrospective case series with prospectively collected outcomes was conducted between 2015 and 2023 in patients undergoing arthroscopic capsular plication for multidirectional shoulder instability with and without hypermobile Ehlers-Danlos syndrome, with a minimum of 2 years of follow-up. Outcomes included American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, and Visual Analog Score pain scores. Failure was defined as recurrent instability or revision surgery.
Results:
Patients showed significant improvement in functional outcome scores and pain after surgery. Failure occurred in 6.7% of patients at a mean of 17 months postoperatively. Clinically meaningful improvement exceeding the minimal clinically important difference was achieved by 100% of patients for American Shoulder and Elbow Surgeons, 65.2% for Single Assessment Numeric Evaluation, and 64.5% for Visual Analog Score pain.
Conclusions:
Arthroscopic capsular plication was associated with meaningful functional improvement and a low failure rate in patients with multidirectional shoulder instability with and without hypermobile Ehlers-Danlos syndrome.
Level Of Evidence:
Level IV, therapeutic-retrospective case series.