Outcomes following arthroscopic pancapsular shift for the treatment of multidirectional instability

Abstract

Objectives: Multidirectional instability of the shoulder (MDI) is a clinical diagnosis that can be difficult to both diagnose and treat. Arthroscopic management of MDI has been used to treat patients with MDI and has the advantage of being able to treat the anterior, posterior, and inferior parts of the capsule. Few studies have presented outcomes with this approach. The purpose of this study is to examine mid-term outcomes after arthroscopic management of multidirectional glenohumeral instability. Methods: In this IRB approved study, patients who underwent arthroscopic stabilization for MDI and were at least 2 years out from surgery were included. MDI was defined by symptomatic glenohumeral instability in 2 or more directions, one of which was inferior. Patients were excluded if they were treated with open surgery or if they had a previous stabilization procedure performed on that shoulder. All patients underwent a pancapsular shift that included tightening posteriorly, inferiorly, and anteriorly with multiple suture anchors and high strength sutures. Patient-reported subjective data was prospectively collected and retrospectively reviewed and included patient satisfaction, instability symptoms, American Shoulder and Elbow Society shoulder index, Single Assessment Numeric Evaluation (SANE), quick Disabilities of the Arm, Shoulder, and Hand score (Quick-DASH), and Short- Form 12 (SF-12) scores. Additional patient-reported information regarding shoulder instability was also collected in the same fashion. Kaplan-Meier survivorship analysis was performed with self-reported postoperative dislocation status. Level of significance was set at p