Thermal Shrinkage for Shoulder Instability

Abstract

The online version of this article (doi:10.1007/s11420-010-9187-7) contains supplementary material, which is available to authorized users.

Feasibility and safety of arthroscopic medial glenohumeral ligament and subscapularis tendon repair with knotless anchors: A cadaveric study in dogs

“…The use of radiofrequency‐induced thermal capsulorraphy has generated controversy in human literature. Failure rates of capsular shrinkage of 31% and 37% are described . Prosthetic reconstruction with suture anchors or bone tunnels is indicated in the most severe cases of MSI and in cases with poor response to conservative management.…”

Arthroscopic Treatment of Shoulder Instability: A Systematic Review of Capsular Plication Versus Thermal Capsulorrhaphy

“…Additionally, Toth et al 12 reported that leaving viable tissue between heat-treated regions, such as in a grid or stripe technique, improved the healing process after TCS. Researchers in 2 studies 15,18 specifically noted that minimal to no tissue was left during the procedure.…”

“…9,12,[15][16][17][18][19][20] In addition to the different types and degrees of instability among the studies, surgical technique varied from a painting style that left no remaining tissue between the treated areas to a striping technique that left minimal tissue between passes. Postoperative management also varied in the period of immobilization and progression of exercises.…”

“…In 1 study, 12 patients were categorized by instability direction: anterior (53%), posterior (6.3%), or MDI (40%), for a total of 80 shoulders, with 25 failures (31%). Surgical techniques were not reported and the only postoperative management described was 4 weeks of immobilization.…”

“…The remaining fibroblasts and vascular cells subsequently repair the tissue, improving its mechanical properties. 3,12 Arthroscopic capsular-shift procedures that use CP have also been developed to mimic the gold-standard open procedure. Techniques vary, with the use of different suture or tack applications, plication and pleating variations, humeral-or glenoid-based shifts, direction of approach, and posterior ''pinch-tuck'' methods.…”