A Randomized Study Comparing Shoulder Surgery With and Without Capsuloplasty to Assess Impact on External Rotation

What this Trial Is About

This research focuses on patients with recurrent anterior shoulder instability undergoing the Latarjet procedure, a common surgical technique. The study aims to evaluate whether adding anterior capsuloplasty to the coracoid buttress repair affects external rotation of the shoulder, which may influence function, joint movement, and return to sports, especially in athletes involved in combat or contact sports. There is currently no consensus among surgeons about the necessity of capsuloplasty in this procedure, and previous studies have shown mixed results regarding its impact on shoulder motion. Participants will undergo one of two surgical procedures open coracoid impingement repair without capsuloplasty or open coracoid impingement repair with a standardized anterior capsuloplasty. Both procedures involve general anesthesia, a semi-sitting position, and a delto-pectoral approach with coracoid osteotomy and fixation to the glenoid using screws. The capsuloplasty technique includes a horizontal repair with an anchor. Surgical and rehabilitation protocols are identical aside from the capsuloplasty. During the study, participants will be monitored for up to 12 months after surgery. Researchers will assess the range of external rotation at 12 months as the primary outcome. Secondary outcomes include recurrence of shoulder instability and the Rowe score at 12 months. The study will help determine the effects of capsuloplasty on shoulder motion and stability, potentially guiding surgical practice for shoulder instability management.

Does Capsuloplasty Reduce External Rotation After Coracoid Impingement?