Arthroscopic reconstruction of traumatic anterior instability of the shoulder: the Caspari technique

In a prospective study, all patients with recurrent traumatic anterior instability of the shoulder were treated by an arthroscopic transglenoid suture reconstruction; 163 consecutive patients were treated during the 3-year period of the study. The average number of dislocations per patient was 11, average age 27 years, and the average preoperative Bankart score 15. All patients underwent reconstruction using the Caspari technique of arthroscopic suture reconstruction. Of the 163 patients, 161 were re-evaluated 36 to 72 months postoperatively. Overall, 147 (91%) of the patients rated as satisfactory and 14 (9%) rated as unsatisfactory. The average postoperative Bankart score for all patients was 89. Twenty of 27 patients (76%) younger than age 18 achieved a satisfactory result. Forty-nine of 54 college-age patients achieved a satisfactory result. In patients older than 22 years, 97.5% (78 of 80) achieved a satisfactory result. In this extensive study, it would appear that the success of this arthroscopic technique is age-related, with younger patients having a less successful result than older patients. Arthroscopic reconstruction with this technique provides results equal to those of the open procedure for patients age 22 years and older and would provide a success rate of 90% in patients age 18 to 22. However, it is effective only 74% of the time in patients younger than 18 and is not indicated for patients in this age range.