Surgical treatment of posterior instability of the shoulder with the posterior-inferior capsular shift

Surgical Principles The posterior-inferior capsular shift is performed to treat recurrent glenohumeral instability that has failed to respond to conservative therapy. Through a posterior approach, the excessively redundant posterior and inferior joint capsule is shifted superiorly to reduce excessive capsular volume. The extent of the lateral capsular dissection inferiorly, as well as the amount of tissue shifted, can be tailored to fit the degree and location of the laxity. When the posterior labrum is found to be detached, it is reattached to the glenoid rim before proceeding with the posterior capsulorrhahy. Bony augmentation of the repair is needed in only rare cases, i.e. in glenoid hypoplasia or in revision capsulorrhaphy procedures.