Capsular Shift / Plication
The loose and redundant shoulder capsule is surgically tightened and reinforced — reducing excessive joint volume and preventing the multidirectional instability that occurs when the shoulder is inherently too lax.
What is Capsular Shift / Plication?
Capsular plication and shift procedures reduce the volume of the shoulder joint capsule — the fibrous lining that surrounds the glenohumeral joint — when it is excessively redundant and allows the humeral head to translate in multiple directions. Unlike Bankart repair which addresses a specific structural tear, capsular procedures tighten the entire capsule to correct global laxity. Arthroscopic plication sutures folds in the capsule to reduce its volume; open capsular shift divides and re-tensions the capsule by anchoring it at a new position. Dr. Sai Kishan selects the most appropriate technique at Lux Hospitals based on the direction and degree of the instability pattern.
How the Procedure Works
Anaesthesia & Joint Laxity Assessment
General or interscalene block; the shoulder is examined under anaesthesia and the drive-through sign confirms pathological capsular laxity before proceeding.
Glenohumeral Arthroscopy
The joint is inspected to confirm the absence of a Bankart tear and to assess the degree and distribution of capsular redundancy.
Arthroscopic Capsular Plication
Sutures are passed through the redundant inferior capsule and tied to fold and tension the tissue, reducing the volume of the inferior pouch.
Open Capsular Shift (where selected)
Through an anterior incision, the capsule is divided in a T-shape and the inferior leaf is shifted superiorly — removing the pouch and applying strong tension to the reconstruction.
Closure & Protected Recovery
Wound closed; sling worn for 4–6 weeks; physiotherapy restores controlled range of motion before building rotator cuff strength progressively.
Outcomes
Who Needs This Treatment?
- →Corrects multidirectional shoulder instability by reducing capsular volume directly
- →Targets the underlying cause — excessive joint laxity — rather than a single direction
- →Arthroscopic plication is minimally invasive with same-day discharge
- →Can be combined with Bankart repair when labral pathology is also present
- →Eliminates the sense of looseness and apprehension that limits shoulder confidence
- →Effective for overhead athletes affected by symptomatic hyperlaxity
Multidirectional instability requires patience — first in trying conservative treatment, and then in selecting the right surgical procedure. When the capsule is the problem, tightening the capsule is the answer.
— — Dr. Sai Kishan Sirasala, Knee and Hip Joint Replacement & Robotic Surgery
Common Questions
Frequently Asked
Not sure which treatment is right for you?
Book a consultation with Dr. Sai Kishan and get a personalised treatment plan.