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Posterior inferior capsulotomy for glenohumeral internal rotation deficit in baseball pitchers (SS-19)

      Glenohumeral internal rotation deficit (GIRD), which is caused by a posterior inferior capsular contracture, has been shown to alter throwing kinematics and glenohumeral translation which predisposes the throwing shoulder to labral pathology and an inability to pitch. Materials and Methods: 11 baseball pitchers (8 professional, 3 college) with severe GIRD (avg. 56°, range 35°–67°) unresponsive to a stretching program, prospectively underwent arthroscopic posterior inferior capsulotomy and were followed for 2 years or more (range 2–5 years). Results: Postoperatively, all patients resumed pitching at their preinjury level or better without symptoms by 6 months and at final follow-up. Immediately following surgery, an average increase of 62° (range 50°–67°) in internal rotation was noted. At final follow-up, GIRD was improved to an average of 16° (range 8°–20°) which represented an average increase of 40° of internal rotation. There were no complications. Conclusions: Posterior inferior selective capsulotomy is highly successful in restoring glenohumeral internal rotation in patients with severe throwing acquired posterior inferior capsular contracture.