Our Summary

This research paper reviews the development and current uses of a surgical procedure called open labral repair with capsular shift. This procedure is used to treat shoulder instability. It has been found to be particularly beneficial for certain groups of patients. These include athletes who participate in high-contact sports, patients with significant instability in their shoulder or instability in multiple directions, and individuals who have had unsuccessful previous shoulder surgery (arthroscopic Bankart repair) without bone loss. The paper also discusses how surgeons doing this open stabilization procedure can use tools and techniques developed for arthroscopic (minimally invasive) procedures. Finally, understanding the history and development of this procedure can help surgeons decide when to use it based on the patient’s specific condition and risk factors.

FAQs

  1. What is the purpose of the open labral repair with capsular shift procedure?
  2. Who are the most suitable patients for the open labral repair with capsular shift procedure?
  3. Can surgeons use tools and techniques from arthroscopic procedures for the open labral repair with capsular shift procedure?

Doctor’s Tip

One helpful tip a doctor might tell a patient about labral repair is to follow their post-operative rehabilitation plan closely. This may include physical therapy exercises to strengthen the shoulder and improve range of motion, as well as restrictions on certain activities to allow the labrum to heal properly. It is important for patients to be diligent in their rehabilitation to achieve the best possible outcome from the surgery.

Suitable For

In summary, patients who are typically recommended for labral repair include:

  1. Athletes who participate in high-contact sports
  2. Patients with significant instability in their shoulder or instability in multiple directions
  3. Individuals who have had unsuccessful previous shoulder surgery (arthroscopic Bankart repair) without bone loss

It is important for surgeons to carefully evaluate each patient’s condition and risk factors before recommending labral repair as a treatment option. By understanding the development and current uses of open labral repair with capsular shift, surgeons can make informed decisions on when to use this procedure for optimal patient outcomes.

Timeline

Before labral repair:

  1. Patient experiences shoulder pain, instability, and decreased range of motion.
  2. Patient undergoes physical examination, imaging tests (such as MRI or CT scan), and possibly a diagnostic arthroscopy to confirm the diagnosis of labral tear.
  3. Surgeon discusses treatment options with the patient, including the possibility of open labral repair with capsular shift.
  4. Patient undergoes pre-operative evaluations and tests to ensure they are healthy enough for surgery.

After labral repair:

  1. Patient undergoes open labral repair with capsular shift surgery, which involves repairing the torn labrum and tightening the shoulder capsule to improve stability.
  2. Patient goes through post-operative recovery period, which may include pain management, physical therapy, and restrictions on shoulder movement.
  3. Patient gradually regains strength and range of motion in the shoulder through rehabilitation exercises.
  4. Patient follows up with the surgeon for regular check-ups to monitor progress and address any concerns.
  5. Patient returns to normal activities, including sports or other physical activities, once cleared by the surgeon.

What to Ask Your Doctor

  1. What is a labral repair with capsular shift and how does it differ from other shoulder stabilization procedures?
  2. Am I a good candidate for open labral repair with capsular shift, or would another procedure be more appropriate for my specific condition?
  3. What are the potential risks and complications associated with this procedure?
  4. What is the typical recovery time and rehabilitation process after undergoing open labral repair with capsular shift?
  5. How successful is this procedure in treating shoulder instability, and what are the long-term outcomes for patients who undergo this surgery?
  6. Are there any alternative treatments or non-surgical options that I should consider before proceeding with open labral repair with capsular shift?
  7. How many times have you performed this procedure, and what is your success rate with it?
  8. What should I expect during the surgery and what type of anesthesia will be used?
  9. Will I need to follow any specific post-operative instructions or precautions to ensure a successful recovery?
  10. Can you provide me with any additional resources or information to help me better understand the procedure and what to expect before, during, and after surgery?

Reference

Authors: Inclan PM, Rodeo SA. Journal: Curr Rev Musculoskelet Med. 2024 Jul;17(7):273-281. doi: 10.1007/s12178-024-09901-2. Epub 2024 Apr 29. PMID: 38683270