Arthroscopic Labrum Reconstruction With Capsular Shift in Anterior Shoulder Instability: Improved Midterm Results by Using a Standardized Suprabicipital Camera Position

Purpose: To investigate the midterm results of a standardized arthroscopic technique for labrum reconstruction by using a third suprabicipital portal for better visualization of the anterior glenoid rim. Methods: Thirty-three of 36 patients treated for recurrent anterior shoulder dislocation were followed up by telephone and/or in clinical examinations. The average age of the patients (12 women and 21 men) at the time of surgery was 25.2 years, with a mean follow-up of 35 months. On average, 7.8 dislocations occurred between the first dislocation and the stabilization procedure (mean, 45.4 months). Results: Two patients suffered again from redislocations (recurrence rate 6.1%), and 3 patients had 1 or 2 subluxations (9.1%) at the time of follow-up. In the Rowe score, the patients reached 77.5 points on average; 81.8% of the patients returned to sports and leisure activities as in the time before the first dislocation, and 18.2% (6 patients) did not. Limitations for external rotation were 7.8° on average postoperatively. No statistical correlation between the number of preoperative dislocations and the level of the postoperative Rowe score was found. Conclusions: The arthroscopic labrum reconstruction with capsular shift using the 3-portal technique combined with a standardized suprabicipital camera position revealed a recurrence rate and midterm results that were close to results achieved after open procedures. The failure rate, according to the number of dislocations, was 6.1% based on the patient’s satisfaction of 12.1%. Level of Evidence: Level IV, therapeutic case series.