Posterior capsulorrhaphy in total shoulder arthroplasty. A case report.

The management of intraoperative posterior instability during total shoulder arthroplasty includes soft tissue balancing, reduction of humeral component retroversion, and augmentation of posterior glenoid defects. Severe instability caused by incompetence of the posterior capsule may require plication of the capsular remnant or a posterior muscle to the glenoid or proximal humerus. A technique of posterior capsulorrhaphy to the proximal humerus is described that does not require a separate surgical approach. By restoring stability, early range of motion exercises can be instituted, eliminating the need for postoperative immobilization. Posterior stability should be assessed during all total shoulder arthroplasties.