ABSTRACT
The rotator interval has been identified as an important anatomic structure contributing to shoulder stability. It is defined as the articular capsule bordered by the superior margin of the subscapularis inferiorly, the leading edge of the supraspinatus superiorly, the base of the coracoid medially, and the long head of the biceps tendon laterally (Fig. 1). It varies in size (1), and its incompetency results in increased glenohumeral translation in all planes (2). Glenohumeral instability is rarely the result of an isolated deficiency of the rotator interval and, therefore, its closure is usually only an adjunct to standard arthroscopic instability repair. While indications remain for rotator interval closure, there is emerging conservatism amongst surgeons specializing in shoulder instability. As such, it should be performed at the end of the procedure, when inferior or posteroinferior instability persists in spite of adequate labral repair and capsular plication (3). Overtightening of the rotator interval is associated with significant loss of external rotation. Various techniques for arthroscopic rotator interval closure have been reported (4-6), which will be presented in this chapter.
