Rockwood Adults CH34

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CHAPTER 34 • Glenohumeral Instability

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Figure 34-44.  A: First anchor is placed percutaneously at the 6 o’clock position ( arrow ). B: Capsular plication is performed with the curved passer penetrating the redundant capsule to assist in the shuttling of the first suture from the anchor. C: The second pass is through the labrum and the second suture from the anchor is shuttled across. These sutures are tied using surgeon’s knots. D: Final arthroscopic capsular plication/shift with three anchors. The patulous capsule is shifted ( star ) to decrease the capsular volume.

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Figure 34-45.  A: Open anterior capsular shift is performed in the beach chair position. A positive sulcus sign ( arrow ) is confirmed with the arm in neutral position and downward-directed force. B: With the arm in external rotation, the sulcus sign is still positive ( arrow ) with downward-directed force which indicates incompetency of the rotator interval.