Does Capsuloplasty Reduce External Rotation After Coracoid Impingement?

NCT07520669 | Recruiting

• 1 other identifier: 2025-65-SBM
• Study Type: interventional
• Target: 104
• Locations: 1 country
• Sites: 1

Brief Summary

The coracoid anchor (Latarjet procedure) is the gold standard technique for treating recurrent anterior shoulder instability. Despite excellent postoperative stability, a reduction in external rotation has been reported, which can affect function, glenohumeral kinematics, and return to sports, particularly among athletes in combat and contact sports. The combination of an anterior capsuloplasty with the coracoid buttress is performed inconsistently among surgeons, with no consensus; the capsular repair techniques associated with the Latarjet procedure vary widely among teams. Some teams routinely perform capsular repair to enhance stability and reposition the capsule on the glenoid rim, while others consider it non-essential and potentially responsible for further limiting external rotation. To date, there are few studies specifically evaluating the impact of capsuloplasty on joint range of motion beyond the end-stop, and the available results remain contradictory. In 2023, the team of Kim et al. suggested that the Latarjet technique without capsular repair resulted in good restoration of laxity and good clinical outcomes, with less early postoperative limitation of external rotation than that observed with the same technique combined with capsular repair. Nevertheless, at 1 year, there was no significant deficit in external rotation between the two groups. A prospective randomized comparative analysis will determine whether the addition of capsuloplasty significantly alters ranges of motion, given identical surgical and rehabilitation protocols. The results could clarify the indications for this procedure, optimize surgical practices, and improve recommendations for the management of shoulder instability.

Conditions

Shoulder Anterior Latarjet Instability

Keywords

instability; dislocation; Latarjet

Outcome Measures

Primary Outcomes (1)

• Range of external rotation

  arm against the body and in 90° abduction : measure of range of external rotation

  12 months after surgery

Secondary Outcomes (2)

• Recurrence of instability

  12 months after surgery

• Rowe score

  12 months after surgery

Study Arms (2)

Open coracoid impingement repair without capsuloplasty

ACTIVE COMPARATOR

Procedure: Open coracoid impingement repair without capsuloplasty

Open coracoid impingement repair with standardized anterior capsuloplasty

EXPERIMENTAL

Procedure: Open coracoid impingement repair with capsuloplasty

Interventions

Open coracoid impingement repair with capsuloplasty PROCEDURE

All patients undergo an open coracoid osteotomy performed using the center's standard technique. The procedure is performed under general anesthesia combined with an interscalene block. The patient is positioned in a semi-sitting position. The approach is delto-pectoral; an osteotomy of the coracoid process is performed after detachment of the acromiocoracoid ligament and the pectoralis minor tendon. A tunnel is created through the subscapularis muscle, followed by a horizontal capsulotomy with placement of guide sutures on both capsular margins. The glenoid is re-contoured, and the stop is then fixed to the glenoid with two screws (Asnis-Stryker, 3.5 mm in diameter). Anterior capsuloplasty is performed using a predefined, reproducible technique: horizontal, with an anchor.

Open coracoid impingement repair with standardized anterior capsuloplasty

Open coracoid impingement repair without capsuloplasty PROCEDURE

All patients undergo an open coracoid osteotomy performed using the center's standard technique. The procedure is performed under general anesthesia combined with an interscalene block. The patient is positioned in a semi-sitting position. The approach is delto-pectoral; an osteotomy of the coracoid process is performed after detachment of the acromiocoracoid ligament and the pectoralis minor tendon. A tunnel is created through the subscapularis muscle, followed by a horizontal capsulotomy with placement of guide sutures on both capsular margins. The glenoid is re-contoured, and the stop is then fixed to the glenoid with two screws (Asnis-Stryker, 3.5 mm in diameter).

Open coracoid impingement repair without capsuloplasty

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Standard indications for surgery (glenoid bone loss, advanced Hill-Sachs lesion, failed Bankart repair, contact sports, etc.).
• Shoulder not previously operated on

You may not qualify if:

• Significant associated rotator cuff pathology, associated SLAP lesion
• Advanced glenohumeral osteoarthritis.
• Recurrent impingement, history of shoulder surgery
• Presence of severe external rotation deficit of the shoulder prior to surgery

Sponsors & Collaborators

• Clinique du Sport, Bordeaux Mérignac: lead

Study Sites (1)

Clinique du Sport

Mérignac, 33700, France

RECRUITING

MeSH Terms

Conditions

Joint Dislocations

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Wounds and Injuries

Study Officials

• Florent Baldairon, MD

  Clinique du sport

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Marion Mandon, PhD

CONTACT

+33 6 78 27 76 72; mmandon@vivalto-sante.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 3, 2026
• First Posted: April 9, 2026
• Study Start: July 2, 2026
• Primary Completion (Estimated): October 31, 2028
• Study Completion (Estimated): December 31, 2028
• Last Updated: July 10, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)