International Journal of Research in Medical Sciences | January 2019 | Vol 7 | Issue 1 Page 301
International Journal of Research in Medical Sciences
Christian SA et al. Int J Res Med Sci. 2019 Jan;7(1):301-304
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Case Report
Arthroscopic posterior-inferior capsular release in the treatment of
overhead athlete with GHIRD: a case report
Stedy Adnyana Christian*, I. G. N. Wien Aryana, I. B. Aditya Wirakarna,
I. G. B. Indra Angganugraha P. J., Komang Arie Trysna Andika, Hafidz Addatuang Ambong,
Soehartono Hadi Pranata
INTRODUCTION
Glenohumeral internal rotation deficit (GHIRD) is one of
most controversial joint diseases in terms of diagnosis
and treatment. The use of arthroscopy has improved the
recognition of pathologic findings in glenohumeral
internal rotation deficit (GHIRD) and allowed a better
understanding of the etiology of it and the correlation
between symptoms and lesion patterns. It can be
observed in overhead athletes and is thought to play a
role in generating pain and rotator cuff weakness in the
dominant shoulder with sport. It is unclear what is an
acceptable value of GIRD in a population of overhead
athletes and whether it should be based solely on internal
rotation deficit or should include total range of motion
(ROM) deficit.
1,2
Acquired GHIRD in the athlete’s throwing shoulder has
been thoroughly documented in the literature as a loss of
internal rotation relative to the non-throwing shoulder,
with etiologies including bony adaptations (increased
humeral retroversion), muscular tightness, and posterior
Department of Orthopaedic and Traumatology, Sanglah General Hospital, Udayana University, Bali, Indonesia
Received: 26 October 2018
Accepted: 30 November 2018
*Correspondence:
Dr. Stedy Adnyana Christian,
E-mail: saylovehoen@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Glenohumeral internal rotation deficit (GHIRD) is one of most controversial joint diseases in terms of diagnosis and
treatment. The use of arthroscopy has improved the recognition of pathologic findings in glenohumeral internal
rotation deficit (GHIRD) and allowed a better understanding of the etiology of it and the correlation between
symptoms and lesion patterns. We present our technique for arthroscopic posterior-inferior capsular release in athlete
with symptomatic glenohumeral internal rotation deficit (GIRD) that was unresponsive to nonoperative treatment and
was preventing him from returning to sport. By this technique resulted in a successful outcome. We evaluate a 28
years old male with right shoulder pain and limitation in abduction internanal rotation after 3 months conservative
treatment. We performed Arthrospcopic posterior-inferior capsular release. After 2 months correspondingly, we
performed follow-up assessments on shoulder function (using the ases and rowe score) and pain (using a visual
analogue scale) were made. Arthroscopic posterior-inferior capsular release can be recommended as a reasonable
operative solution for overhead athletes with symptomatic GIRD that has not responden to conservative management.
Evaluation of patient in whom we performed arthroscopic repair base on ases and rowe score. Arthroscopic posterior-
inferior capsular release showed satisfactory shoulder function after 2 months follow up correspondingly.
Keywords: Arthroscopic, Athlete, GHIRD, Posterior-inferior capsular
DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20185397