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.