Anterior labrum reconstruction with mini-capsular shift procedure.
An anterior labrum reconstruction and mini-capsular shift (ARMS) procedure was performed in 64 patients (69 shoulders) with traumatic anterior or anterior-inferior glenohumeral instability between 1984 and 1990. Sixty-three of the sixty-nine stabilizations were performed for recurrent dislocation and six were performed for recurrent subluxation. Eighty-eight percent of the patients (61 shoulders) were available for clinical follow-up at an average of 36 months (range 28-78). There were 44 males and 12 females with an average age of 28 years (range 15-46). Excellent range of motion was recorded at follow-up for the operated shoulder with an average of 180 degrees of forward elevation, 72 degrees of external rotation with the arm at the side, 92 degrees of external rotation with the arm in the 90 degree abducted position and 90 degrees of internal rotation with the arm in the 90 degree abducted position. The range of motion of the normal shoulder was 180 degrees, 76 degrees, 101 degrees and 94 degrees respectively. Utilizing the rating scale from the American Shoulder and Elbow Society, pain improved from 3.1 to 4.4, stability improved from 1.1 to 4.5, and function improved from 2.5 to 3.8 on the average. Subjective rating revealed 95% of the patients to be satisfied with the operative procedure. According to the criteria of Rowe et al, 90% of the results were good or excellent. Five patients (8%) suffered a recurrent dislocation at an average of 32 months after the surgery. Four resulted from significant trauma (6%). One patient (2%) complained of a single episode of subluxation during early recovery. Two patients required shoulder manipulations to improve motion. No other complications occurred. The patients reviewed in this study were actively involved in sports. The majority of pre- and postoperative Tegner ratings exceeded 7.0.