Loss of external rotation following anterior capsulorrhaphy of the shoulder.

A retrospective study was performed on twenty shoulders in nineteen patients who had been managed for severe loss of external rotation of the glenohumeral joint after a previous anterior capsulorrhaphy for recurrent instability. All patients had noted a restricted range of motion, and seventeen shoulders had been painful. In seven shoulders, the humeral head had been subluxated or dislocated posteriorly, and sixteen shoulders had been affected by mild to severe glenohumeral osteoarthrosis. All twenty shoulders were treated with a reoperation, which consisted of a release of the anterior soft tissue. In addition, eight shoulders had a total arthroplasty and one had a hemiarthroplasty. At an average duration of follow-up of forty-eight months, all shoulders had an improvement in the ratings for pain and range of motion. The average increase in external rotation was 45 degrees (range, 25 to 65 degrees). Patients who have a major loss of external rotation following anterior capsulorrhaphy of the shoulder may be at risk for the development of posterior subluxation and glenohumeral osteoarthrosis. The performance of an anterior release should be considered for these patients.