Shoulder Labral Repair | Shoulder Instability Treatment

In this video, Dr. Millett discusses arthroscopic pancapsular shift with labral repair for multidirectional shoulder instability. In this case report, the patient's symptoms are anterior, posterior and inferior. After failed conservative nonoperative treatment, the patient elected to undergo an arthroscopic capsular plication shoulder labral repair.

The patient is positioned in a vertical suspension with 80 degrees of abduction and minimal forward flexion using 15 pounds of traction. A diagnostic arthroscopy is performed. In the case example, the labrum is detached anteriorly from the 2 o'clock to the 6 o'clock position. There is also a labral tear present that extends from the 7 o'clock to 11 o'clock position.

Shoulder specialist Dr. Millett prefers to start with the more unstable side because it permits for a larger capsular shift. In this case, we start with the anterior position. 4 anchors are placed and the repair sutures are placed. The posterior labral repair is then addressed. 4 anchors are placed and sutures are passed.

Post-operative rehabilitation includes immobilization for 6 weeks, followed by passive motion. 6-7 weeks begin active and active-assisted motion. At 7 weeks strengthening will begin and at 4-5 month patients can return to full activities.