High risk of capsular restretching found among women and elite athletes
Even after successful arthroscopic Bankart repair and capsular shift, women, elite athletes and patients with frequent dislocations were at high risk of capsular restretching, according to study results.
Researchers evaluated the functional outcomes of 105 patients who underwent arthroscopic Bankart repair and capsular shift for anterior shoulder instability and computed tomography arthrography (CTA) at 3 months and 1 year postoperatively. Of the 105 patients, 27 patients also had preoperative CTA, which was used to compare preoperative and 3-month postoperative CTA measurements, while all 105 patients were used for all other comparisons.
The separate anterior and posterior capsular volume and cross-sectional area at the 5-o’clock position were measured using 3-D software and subsequently adjusted for each glenoid size. The researchers also evaluated the changes in capsular volume and cross sectional area at the 5-o’clock position over time, the factors related to higher change in anterior capsular volume and their correlation with outcomes.
Seok Won Chung
Results showed the total and anterior capsular volume and anterior cross-sectional area significant decreased by 3 months postoperatively. However, at 1 year postoperatively, the researchers found these values increased again. The researchers also found excellent inter- and intraobserver reliabilities of measurements.
A higher increase in anterior capsular volume at 1 year was related to female sex, being an elite athlete and more dislocations before surgery, according to study results.
Although patients who experienced redislocation or who exhibited positive apprehension test postoperatively showed significantly higher increases in anterior and total capsular volume at 1 year, the researchers found a higher increase in anterior capsular volume was not related to functional outcome measures, with the exception of Rowe score. – by Casey Tingle
Disclosure: This research was supported by the Konkuk University Medical Center Research Grant 2014.