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Management of Capsular Deficiency of the Shoulder A Report of Three Cases
Jon J.P. Warner, MD; Andreas A. Venegas, MD; Janne T. Lehtinen, MD; John J. Macy, MD
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Investigation performed at The Harvard Shoulder Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts; University Hospital, Bogota, Columbia; and University Hospital, Tampere, Finland

Jon J.P. Warner, MD
Andreas A. Venegas, MD
John J. Macy, MD
The Harvard Shoulder Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Professional Office Building, Suite 403, 275 Cambridge Street, Boston, MA 02114. E-mail address for J.P. Warner: jwarner@partners.org

Janne T. Lehtinen, MD
Kiuruntic 21, 36200 Kangasala, Finland. E-mail address: janaemd@rokki.net
The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

J Bone Joint Surg Am, 2002 Sep 01;84(9):1668-1671
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Most patients with anterior shoulder instability can be successfully treated with conventional operative techniques 1-7 . However, in rare cases, capsular deficiency precludes direct repair of the glenohumeral capsule and labrum. This type of deficiency usually occurs after multiple failed operations; however, it can occur without prior surgery 8-11 . Several treatment alternatives have been reported in the literature, but experience is limited 8,10,11 . The Laterjet procedure 12 provides an extra-articular method of reconstruction, which may, however, potentially complicate later revision surgery. Furthermore, problems with bone block and screw placement have been noted.
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