title: Electrothermally-assisted capsulorrhaphy (ETAC): a new surgical method for glenohumeral instability and its rehabilitation considerations.
abstract: Knowledge of current surgical procedures and the effect they have on healing tissue is important when developing rehabilitation guidelines. Recently, clinicians have been asked to treat patients who have undergone Electrothermally-Assisted Capsulorrhaphy (ETAC) for shoulder instability. The ultimate tensile strength of the tightened capsule is unknown during various timeframes following surgery. The use of thermal energy to shrink the shoulder joint capsule initially causes weakness of the collagen ultrastructure. Rehabilitation following ETAC includes a period of relative immobilization, followed by controlled range of motion exercises. Exercises to strengthen shoulder muscles must be done in a manner that minimizes stress on the surgically treated capsule. This article provides a brief review of capsuloligamentous repair; describes the surgical procedure, its indications, contraindications, and the effect ETAC has on the healing tissue; and provides guidelines for rehabilitation following ETAC based on the evidence available and the authors clinical experience.
authors.affiliation: Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, NY 10021, USA. tyler@nismat.org
authors.forename: T F
authors.initials: TF
authors.lastname: Tyler
authors.forename: G J
authors.initials: GJ
authors.lastname: Calabrese
authors.forename: R D
authors.initials: RD
authors.lastname: Parker
authors.forename: S J
authors.initials: SJ
authors.lastname: Nicholas
mesh_terms: D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D017746:Joint Capsule / Q000473:pathology* / Q000502:physiology / Q000601:surgery; D007593:Joint Instability / Q000473:pathology / Q000534:rehabilitation* / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D011183:Postoperative Complications; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery*; D013718:Tensile Strength