Capsular Shift / Capsular Plication
Surgical tightening of a loose shoulder capsule to restore joint stability, prevent recurrent subluxations, and improve shoulder control — particularly for multidirectional instability.
What is Capsular Shift / Capsular Plication?
Capsular Shift or Capsular Plication surgically tightens a loose or overstretched joint capsule — the soft-tissue envelope that holds the humeral head within the glenoid socket. When the capsule becomes lax due to repeated dislocations, sports injuries, or generalised ligament laxity, the shoulder may subluxate (partially slip) or dislocate in multiple directions. The procedure reinforces the capsule either by folding and suturing it inward (plication) or by shifting and repositioning it (shift), restoring the normal tension needed for a stable joint. It is the treatment of choice for multidirectional shoulder instability when physiotherapy alone has not provided sufficient improvement.
How the Procedure Works
Pre-operative MRI Assessment
MRI evaluates capsular laxity, labral integrity, and the direction and severity of instability; the surgical plan is tailored accordingly
Anaesthesia & Arthroscopic Access
Regional or general anaesthesia is administered; small keyhole incisions allow the arthroscope to fully visualise the capsule and surrounding joint structures.
Capsule & Joint Evaluation
The surgeon assesses capsular volume, laxity, and any associated labral, ligament, or chondral injuries within the shoulder joint.
Capsular Tightening
— Using arthroscopic instruments, the loose capsular tissue is gathered or folded; sutures reduce capsular volume and restore the correct degree of joint tension.
Shift or Plication
— Depending on the instability pattern, a capsular shift (repositioning) or plication (folding) is performed to achieve balanced, multi-directional stability.
Stability Check & Wound Closure
— Joint stability in all planes is confirmed; instruments are removed, incisions are closed, and the arm is supported in a sling.
Outcomes
Who Needs This Treatment?
- →→ Directly addresses the cause of multidirectional instability
- →→ Tightens and reinforces the loose capsule without bone procedures
- →→ Restores shoulder stability and control for overhead activities
- →→ Reduces the risk of recurrent subluxations and dislocations
- →→ Reduces t→ Minim“Multidirectional shoulder instability can be frustrating — the shoulder feels loose in multiple directions and keeps slipping. Capsular plication addresses this directly by tightening the capsule from the inside, restoring the tension and control that the joint needs to function confidently.”ally invasive arthroscopic technique — smaller incisionshe risk of recurrent subluxations and dislocations
- →Most patients return to sports and physical activities after completing rehabilitation and restoring full shoulder strength and stability.
“Multidirectional shoulder instability can be frustrating — the shoulder feels loose in multiple directions and keeps slipping. Capsular plication addresses this directly by tightening the capsule from the inside, restoring the tension and control that the joint needs to function confidently.”
— Dr. Satish Reddy Gandavarapu, Senior Orthopaedic & Trauma Surgeon, Lux Hospitals, Hyderabad
Common Questions
Frequently Asked
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