When is rotator interval repair necessary in the management of shoulder instability?
Rotator interval repair in the treatment of glenohumeral instability is an evolving issue. The anatomy of the interval appears different if viewed it from the joint side, as in arthroscopy, rather than from the external side, as in open repair. The variability of the capsular anatomy within the interval also is a factor. In the arthroscopic treatment of traumatic, recurrent anterior shoulder instability, I have never imbricated the rotator interval. The lesion of anterior instability is “below the equator” on the glenoid of the shoulder, while the interval is “above the equator.” Overzealous repair or closure in the interval region can lead to external rotation loss. This can compromise the functional result of the surgical procedure. Interval closure should not be included in most instability repairs. Interval closure may be more appropriate to consider in patients with true multidirectional instability. In these cases, the capsule is capacious and globally lax. Typically the posterio
