Arthroscopic Capsular Shift from Inferior to Superior has an Exceptional Safety Profile and Short-Term Outcomes.

OBJECTIVES: Arthroscopic Bankart for anterior shoulder instability has a good safety profile but with a relatively high recurrence index. Open surgery has been used to decrease recurrence rates but with a higher complication rate. Arthroscopic Capsular Shift from Inferior to Superior (ACSIS) was designed to decrease the recurrence rates without the added morbidity of open surgery.

METHODS: An observational retrospective study was conducted to analyze perioperative complications and patient reported outcomes of patients treated with ACSIS to determine the safety profile of the procedure. The patients with anterior traumatic shoulder instability treated with ACSIS between January 2015 and December 2021 were included for the study. The analysis was conducted using SPSS (Version 27). The pre vs. postoperative Western Ontario Shoulder Instability (WOSI) Index scores were compared using a paired sample t-test or Wilcoxon signed ranks test depending on the results of the normality test and Levene's test. The significance level was 0.05 in all analyses. Thirty-six patients were included in this study, the mean age of the population is 30.8±11.4 years, with a male dominance of 86.1% (N=31), and a mean clinical follow-up of 2.7±1.2 years.

RESULTS: No intraoperative complications, including bleeding or neurovascular injury, were noted. Additionally, no early postoperative complications, including infection or hospital readmission, were noted. During the follow-up, one patient (3%) had persistent apprehension. The mean WOSI index decreased from 66.6±13.10% to 27.9±22% postoperatively (P<0.001).

CONCLUSIONS: ACSIS procedure is safe and has good short-term outcomes with a low recurrence rate at 1-year minimum follow-up.

LEVEL OF EVIDENCE: 3 (Observational study).