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Arthroscopic anterior capsular plication

Overview

This is the procedure of choice in those who dislocate the shoulder anteriorly and in whom the front lining membrane (Capsule) of the shoulder joint is unduly lax. The objective of the surgery is to tighten the anterior capsule.  This is done as an arthroscopic procedure.

Steps of the Surgery

Two or three tiny incisions of less than 1cm are made around the shoulder joint. A tubular camera is introduced through one of the incision and thorough visualisation of the joint is made. This gives a chance to confirm the problem and a plan can be executed. If it is found to be an abnormally lax anterior capsule then two or three tightening stitches are applied in the capsule at about 0.5cm interval from below to above. Special arthroscopic needles are used to pass the stitches through the capsule and arthroscopic knots are applied. This tightens the capsule. To reinforce the tightening, a radiofrequency probe is used to contract the tissues. The radiofrequency probe emanates heat and shrinks the collagen (basic building material of the capsule) and helps to tighten the capsule further.

Postoperative stage

Immediately after the procedure, a sling will be given to rest the arm. The movements that can put tension on the repaired structures are prevented for a duration of 4 – 6 weeks. Further to that the movements are encouraged. A systematic physiotherapy programme will be initiated to get the full function back.

The Success Rates and the Outcomes

The arthroscopic procedure is pretty safe. The pain is minimal as the procedure is done through tiny stab incisions.

Complications

Infection, chondral damage, nerve damage is possible complications but the reported incidences are rare.