Capsular Shift (Shoulder)
A surgical procedure to tighten the shoulder capsule and improve joint stability
Capsular shift surgery aims to address shoulder instability by reducing excessive laxity in the joint capsule.
Common Reasons for Surgery
- Chronic shoulder instability or frequent dislocations.
- Generalised joint looseness (laxity) due to overuse or inherent hypermobility.
- Symptoms such as pain, weakness, or a sense of the shoulder “slipping out.”
Goals of the Procedure:
- Improve shoulder stability by tightening the joint capsule.
- Reduce the risk of recurrent dislocations.
Alleviate pain and enhance mobility and function.
Preparation for Surgery
Proper preparation is crucial to optimise surgical outcomes.
Steps in Preparation:
- Pre-Surgical Consultations and Imaging:
- Dr Ben McGrath may order X-rays, MRIs, or other imaging to assess the extent of instability and identify any associated damage.
- Optimising Health:
- Strengthening the shoulder through prehabilitation exercises may improve recovery.
- Lifestyle changes, such as ceasing smoking or managing weight, can promote better healing.
- Pre-Surgical Instructions:
- Follow fasting guidelines before surgery.
- Discuss any medications you take, as some may need to be adjusted.
What Happens During the Surgery?
Capsular shift surgery is typically performed arthroscopically, though an open approach may be necessary for complex cases.
Surgical Steps:
- Anaesthesia:
- The procedure is performed under general anaesthesia.
- Capsular Tightening:
- Small incisions are made to insert an arthroscope and surgical instruments.
- The joint capsule is tightened by folding and suturing the excess tissue to reduce laxity.
- Closure:
- The incisions are closed, and a sterile dressing is applied.
The surgery usually takes one to two hours, depending on the complexity of the condition.
Understanding the Risks
Capsular shift surgery is generally safe, but like all surgeries, it carries certain risks.
Common Risks:
- Temporary pain or swelling around the shoulder.
- Reduced range of motion during the early recovery phase.
Rare but Serious Risks:
- Infection at the surgical site.
- Damage to nearby nerves or blood vessels.
- Recurrence of instability despite the repair.
Dr McGrath will discuss these risks in detail and outline the steps taken to minimise them.
What to Expect After Surgery
Immediate Post-Operative Care:
- The shoulder will be immobilised using a sling to protect the repair.
- Pain management will be addressed with prescribed medications.
Discharge Instructions:
- Care instructions for the surgical site, including keeping it clean and dry.
- Guidelines on using the sling and avoiding movements that may strain the shoulder.
Rehabilitation and Recovery
Rehabilitation is key to a successful recovery following capsular shift surgery.
Recovery Timeline:
- Early Phase (Weeks 0–6):
- Focus on protecting the shoulder and performing passive range-of-motion exercises under supervision.
- Strengthening Phase (Weeks 6–12):
- Gradual introduction of active motion and strengthening exercises.
- Functional Recovery (Months 3–6):
- Progressively return to daily activities, sports, or work as permitted by Dr McGrath and your physiotherapist.
Restrictions:
- Avoid heavy lifting or strenuous activities during the early recovery phase.
- Follow all rehabilitation protocols to minimise the risk of re-injury.
Long-Term Outcomes
Capsular shift surgery is often recommended to improve shoulder stability and prevent recurrent dislocations.
Expected Improvements:
- Reduced risk of shoulder dislocations.
- Increased stability and strength in the shoulder joint.
- Enhanced quality of life through restored function and reduced pain.
Maintenance of Results:
- Adhere to your physiotherapy program.
- Avoid activities that could strain the repaired shoulder during the healing period.
- Schedule follow-up appointments with Dr McGrath to monitor your progress.