Arthroscopic Capsular Plication Shows Low Failure Rates and Meaningful Functional Improvement in Multidirectional Shoulder Instability With and Without Hypermobile Ehlers-Danlos Syndrome.

PURPOSE: To evaluate clinical outcomes and failure rates after arthroscopic capsular plication for multidirectional shoulder instability in patients with and without hypermobile Ehlers-Danlos syndrome. METHODS: A retrospective case series with prospectively collected outcomes was conducted between 2015 and 2023 in patients undergoing arthroscopic capsular plication for multidirectional shoulder instability with and without hypermobile Ehlers-Danlos syndrome, with a minimum of 2 years of follow-up. Outcomes included American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, and Visual Analog Score pain scores. Failure was defined as recurrent instability or revision surgery. RESULTS: Patients showed significant improvement in functional outcome scores and pain after surgery. Failure occurred in 6.7% of patients at a mean of 17 months postoperatively. Clinically meaningful improvement exceeding the minimal clinically important difference was achieved by 100% of patients for American Shoulder and Elbow Surgeons, 65.2% for Single Assessment Numeric Evaluation, and 64.5% for Visual Analog Score pain. CONCLUSIONS: Arthroscopic capsular plication was associated with meaningful functional improvement and a low failure rate in patients with multidirectional shoulder instability with and without hypermobile Ehlers-Danlos syndrome. LEVEL OF EVIDENCE: Level IV, therapeutic-retrospective case series.