Suture capsulorrhaphy versus capsulolabral advancement for shoulder instability.

PURPOSE The purpose of this study was to test the strength of a suture capsulorrhaphy repair versus a capsulolabral repair with knotless suture anchors in a cadaveric model with anteroinferior shoulder instability. METHODS Fourteen cadaveric shoulders were tested with either a suture capsulorrhaphy to the intact labrum or a capsulolabral advancement using a knotless suture anchor into the glenoid. Specimens were translated with the shoulder in an abducted, externally rotated position to failure. RESULTS The capsulolabral advancement showed a significantly higher load to failure than did the suture capsulorrhaphy group (P = .030). CONCLUSIONS Capsulolabral advancement with suture anchors may offer greater initial strength when compared with a suture capsulorrhaphy. In the setting of shoulder instability without evidence of a labral tear, the capsulolabral advancement technique may be considered biomechanically superior. CLINICAL RELEVANCE In the setting of shoulder instability due to capsular insufficiency, the capsulolabral advancement may be considered biomechanically superior to a traditional suture capsulorrhaphy.