Capsular Shift
Another surgery to tighten a loose shoulder joint is a procedure called a capsular shift. The lining of any joint is called the joint capsule. The joint capsule forms a pocket, or bag that is made up of the ligaments and connective tissue around the joint. The shoulder joint has a fairly large joint capsule that is necessary to allow the joint to move in such a wide range.
Sometimes the problem causing the shoulder instability is because the joint capsule is simply too large. This is sometimes referred to as a redundant, or patulous joint capsule. This may cause shoulder instability in multiple directions. This is sometimes referred to as multi-directional instability. In order to fix this type of instability, the joint capsule needs to be made smaller and tightened.
This procedure also can be performed using the arthroscope. The surgeon pulls the flap of tissue over the front of the capsule and connects it together. This is similar to when a tailor tucks loose fabric by overlapping and sewing the two parts together. Once the appropriate degree of tightness is achieved, the surgeon uses a combination of sutures and suture anchors to hold the joint capsule in this position until healing occurs.