Open Instability Repair: The Anterior-Inferior Capsular Shift

Shoulder dislocations in the young patient have been shown to have a high risk of recurrent dislocation or symptomatic subluxation. Repeated episodes of instability can be disabling in the short term and lead to long term degenerative changes of the glenohumeral joint. The associated injuries involve an avulsion of the anterior-inferior glenoid labrum as well as deformation of the capsule. There is a higher rate of failure if these injuries are not addressed at the time of surgery. This article describes our technique of surgical management of recurrent anterior instability: the anterior-inferior capsular shift. This approach includes both capsular shift as well as reattachment of the displaced labrum. This technique allows for titration of the capsular plication for the individual patient.