Rotator Interval Plication: What is the indication?
Authors: L Field
References: Practical Arthroscopy September 2004
Dr Larry Field reviewed the literature and his experience with closure of the rotator interval. The generic indications in the past have been for a congenitally patulous capsule, a traumatic SGHL avulsion, and, in some cases, to back up an anterior stabilisation. Instability has always been a “soft” indication performing an interval closure. Some would always do a plication of the interval if the patient had a degree of sulcus sign, but most agree that there are no well defined guidelines for this procedure. He showed examples of the wide variation of normal and abnormal anatomy of the interval. Field does a two-layer all-inside modification of the Taverna technique. He suggested that the following were indications for interval closure: - All cases of MDI - Some anterior reconstructions - Some SLAP repairs - All posterior reconstructions - Internal impingement
He feels that interval plication increases shoulder stability, and is a valuable supplement to MDI and posterior reconstructions. It is important to avoid over tightening and decreasing external rotation.