Stabilisation

ANTERIOR/INFERIOR CAPSULAR SHIFT
Purpose

To restore normal volume of the capsule (or lining) of the glenohumeral (or shoulder joint) and restore normal tension and length of the stretched ligaments following recurrent dislocation.
Indications

Patients with recurrent instability and/or dislocation which is caused by multi-directional joint laxity rather than a localized defect (usually as a result of several dislocations)
Skin Incision
Deltopectoral approach.

 

Approach

Superficial muscles are separated and deep muscles are divided. The capsule of the joint is opened. All these structures are repaired at the end of the procedure.

 

Procedure

The capsule of the joint is dissected from the muscle anteriorly and inferiorly and divided by an –I incision. The two flaps of capsule are overlapped which shifts the inferior capsule and reduced the overall volume of the joint capsule. Two suture anchors are inserted into the anterior margin of the glenoid bone, allowing the tissues to heal in this position. These embedded ‘anchors ‘ grip the bone and allow the overlapped capsule to be tightened against the glenoid bone.

Possible associated procedures

  • Examination under Anaesthesia
  • Arthroscopic assement of the glenohumeral joint and sub acromial bursa
  • Bankart Repair ( link)

Main Possible Complications

    • Infection
    • Damage to nerve and blood vessels
    • Recurrence of anterior instability
    • Shoulder stiffness
      After your operation
  • The arm will be rested in a controlled position in a sling or brace. The physiotherapist and nursing staff will show you how to adjust and safely remove and re apply this.( Link to ULTRASLING II ER and living with a sling)
  • You will not need an x ray.
  • You will typically be able to go home the same day or the day after surgery.
  • You can expect to need painkillers for the first 2 weeks after surgery to control the background pain. You will also need to take painkillers an hour before each physiotherapy or heavy exercise session for up to 6 weeks longer.
  • You will be shown specific shoulder and arm exercises by your physiotherapist before you leave the hospital. These exercises are very important and must be carried out accurately after leaving hospital on a daily basis at home; ideally 3 times a day. It is very important that you DO NOT EXTERNALLY ROTATE the shoulder during the first 4 weeks after surgery. Make sure that you are shown this by your physiotherapist before leaving hospital.
  • The stitches must be removed or the wound inspected (if absorbable sutures are used) at 14 days after surgery; either with your GP’ practice nurse or at the hospital.