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- Title
Prospective Evaluation of Thermal Capsulrrhaphy for Shoulder Instability.
- Authors
Donald F. D'Alessandro, Bruce; Bradley, James P.; Fleischli, James E.; Connor, Patrick M.
- Abstract
Background: Thermal shrinkage of capsular tissue has recently been proposed as a means to address the capsular redundancy associated with shoulder instability. Although this procedure has become very popular, minimal peer-reviewed literature is available to justify its widespread use. Purpose: To prospectively evaluate the efficacy of arthroscopic electrothermal capsulorrhaphy for the treatment of shoulder instability. Study Design: This nonrandomized prospective study evaluated the indications and results of thermal capsulorrhaphy in 84 shoulders with an average follow-up of 38 months. Methods: Patients were divided into three clinical subgroups: traumatic anterior dislocation (acute or recurrent), recurrent anterior anterior/inferior subluxation without prior dislocation, and multidirectional instability. Patients underwent arthroscopic thermal capsulorrhaphy after initial assessment, radiographs, and failure of a minimum of 3 months of nonoperative rehabilitation. Results: Outcome measures included pain, recurrent instability, return to work/sports, and the American Shoulder and Elbow Surgeons (ASES) Shoulder Assessment score. Overall results were excellent in 33 participants (39%), satisfactory in 20 (24%), and unsatisfactory in 31(37%). Conclusions: The high rate of unsatisfactory overall results (37%), documented with longer follow-up, is of great concern. The authors conclude that enthusiasm for thermal capsulorrhaphy should be tempered until further studies document its efficacy.
- Subjects
ORTHOPEDIC disability evaluation; SHOULDER dislocations treatment; CONNECTIVE tissues; DIAGNOSIS; ARTHROSCOPY; THERAPEUTICS
- Publication
American Journal of Sports Medicine, 2004, Vol 32, Issue 1, p21
- ISSN
0363-5465
- Publication type
Article
- DOI
10.1177/0095399703258735