APEX Shoulder Mastering Surgical Techniques for Clinical Success-MDI_ Balancing the Shoulder All the Way Around

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Video Summary

This talk addresses multidirectional shoulder instability, emphasizing the importance of defining pathology and understanding the roles of the labrum, capsule, and proprioception. Originating from Neer and Foster’s concept of inferior capsular shift, surgical treatment focuses on reducing capsular volume and balancing anterior, posterior, and inferior stability. Diagnosis hinges on symptomatic inferior and anterior-posterior translation, often linked to ligamentous laxity and scapular issues. Pathology involves loss of dynamic stability and proprioception rather than labral tears. Surgery is reserved for persistent cases after rehab targeting proprioception and scapular control. Arthroscopic techniques include capsular imbrication and rotator interval closure to restore stability, followed by prolonged rehab.

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Robert Litchfield, MD

Keywords

multidirectional shoulder instability

inferior capsular shift

capsular volume reduction

proprioception rehabilitation

arthroscopic capsular imbrication