Glenohumeral joint translation after arthroscopic thermal capsuloplasty of the rotator interval.
The treatment of recurrent anterior, posterior, or multidirectional glenohumeral instability by operative closure of the rotator interval has been proposed. The purpose of this study was to determine whether arthroscopic thermal capsuloplasty of the rotator interval with the radiofrequency probe significantly decreases anterior-posterior glenohumeral translation. Anterior and posterior loads of 10, 15, and 20 N were sequentially applied to 8 cadaveric shoulder joints while mounted in a translation testing apparatus with an electromagnetic tracking device measuring anterior and posterior glenohumeral translation. Arthroscopic thermal capsuloplasty was then performed on the rotator interval with a radiofrequency probe. The identical anterior-posterior loading protocol was then repeated, and translations were recorded. The results showed a significant reduction in anterior and posterior translation after thermal capsuloplasty. After rotator interval thermal capsuloplasty, anterior translation decreased by 31.5%, 28.8%, and 27.2% for the 10-, 15-, and 20-N loads, respectively. Posterior translation decreased by 43.1%, 43.8%, and 40.7%, respectively. The results of this study indicate that arthroscopic thermal capsuloplasty of the rotator interval is an effective way by which to decrease both anterior and posterior glenohumeral translation in vitro. To date, no in vivo studies that sufficiently document long-term clinically successful outcomes of such a procedure exist. Future studies are warranted to evaluate the effects of the biologic response to thermal shrinkage and whether these reduced glenohumeral translations will be maintained.
Selecky
Mark T
MT
Kerlan Jobe Orthopaedic Clinic, Los Angeles, USA.
Tibone
James E
JE
Yang
Bruce Y
BY
McMahon
Patrick J
PJ
Lee
Thay Q
TQ
D000368:Aged; D001178:Arthroplasty / Q000379:methods; D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena; D002102:Cadaver; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods; D017746:Joint Capsule / Q000473:pathology / Q000601:surgery*; D007593:Joint Instability / Q000601:surgery; D011846:Radio Waves; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*