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Capsular Deficiency

Fortunately, capsular deficiency is a rare condition. There is a paucity of literature that deals with soft tissues deficiency in relation to instability. It is more common in revision settings and after thermal capsulorraphy. The soft-tissue deficiency may also include the subscapularis. There are several reasonable surgical options and choices for soft tissue augmentation for the unstable shoulder with a deficient capsule.

Lazarus et al.It presented a method of using hamstrings for repair of such deficiencies. Good outcomes, using a modification of this technique, have been reported by Warner et al.Gallie et al. It described the use of the iliotibial band for capsular reconstruction to treat glenohumeral instability associated with an irreparable capsule. More recently Iannotti et al.

It have reported their experience in seven cases using this technique. Results were generally good with no recurrences or problems with persistent apprehension. Moekel et al.It have described the use of Achilles allograft in the setting of anterior instability after shoulder arthroplasty.

The researchers reported on 10 patients with persistent anterior shoulder instability from a series of 236 total shoulder arthroplasties. The results were generally fair to good with some loss of motion but restoration of stability.

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