Abstract
Our purpose to the clarify long-term postoperative results of recurrent anterior dislocations and subluxations after Neer's modified inferior capsular shift procedure (MICS) and the risk factors causing their recurrences. Ninety-five patients (96 shoulders, 79 males and 16 females, 62 dislocations and 34 subluxations) were examined directly and by phone more than 5 years after MICS (ave. 82 mos. ; 5-12 yrs.). The post-operative results were evaluated by a manual translation test, an apprehension test, ROM, Rowe's score at their final follow-up. Risk factors causing postoperative recurrence of dislocation or subluxation were clarified. General joint laxity (GJL) was seen in 10 (11%) patients. There had 43 (45%) contact sports players and 44 (46%) patients were competitive level players. Postoperatively, 8 cases (8.3%) were recurred. Five (8%) and 6 (10%) patients showed positive anterior apprehension and anterior translation tests. The average ROM loss was 1.1° in elevation, 9.9° in the external rotation at the side and 9.3° in the external rotation at 90° abduction. The Rowe score at the final follow-up showed excellent in 72 (75%), good in fourteen (15%), fair in three (3%), and poor in seven (7%) patients. Five items [preoperative factors; subluxation, positive GJL, contact sport players, competitive sports level and intraoperative factor: arm-position at capsulorrhaphy (20≤ER)] were considered to be risk factors of a recurrence. The recurrent rate was 8.3 % over 5 years after MICS. It was recommended that patients having preoperative risk factors should be operated with 10° ER capsulorrhaphy.
