L-Type
Arthroscopic Capsular Shift for unidirectional Instability
Using standard arthroscopic
maneuvers shoulder surgeons can expect excellent results for arthroscopic
cruciate capsular repair to correct the midsubstance ligamentous laxity rather
than only repairing a bankart lesion leaving the anterior capsule redundant
(Fig. 1).
This technique is easy, quick, cheap and allows anatomical
reconstruction through reefing and doubling of the anterior
capsular-ligament component.
1.
On the neck of the head a trough is made for attachment of the
ligament.
2.
An L-Type incision is made to shift the inferior glenohumeral
ligament capsular component superiorly.
3.
A Chop Needle placing a
.suture through the edge of the prepared flap and a Chop Puller pulls the
posterior limb up to the upper lateral border of the subscapularis.
4.
With the chop puller the
anterior suture limb is pulled below the upper border of the subscapularis.
5.
The two ends of
the suturepass below and above the
upper border of the subscapularis.
A knot is tied
using the concave knot driver to shift the capsule superiorly.
