Glenohumeral joint translation after arthroscopic thermal capsuloplasty of the posterior capsule.
Treatment of recurrent posterior or multidirectional glenohumeral instability in athletes with traditional operative management has produced variable results at long-term follow-up. The purpose of this study was to determine whether an arthroscopic thermal capsuloplasty of the posterior capsule with a radiofrequency probe significantly decreases anterior-posterior glenohumeral translation. Successive posterior and anterior loads of 10, 15, and 20 N were applied sequentially to 7 cadaveric shoulder joints that were mounted in a translation testing apparatus with an electromagnetic tracking device measuring posterior and anterior glenohumeral translation. Arthroscopic thermal capsuloplasty was then performed on the posterior capsular tissue with a radiofrequency probe. The identical posterior-anterior loading protocol was then repeated, and translations were recorded. The results demonstrated no statistically significant differences in the mean posterior translation measurements before and after arthroscopic thermal capsuloplasty of the posterior capsule for the 10-N (+8.9%), 15-N (-3.1%), or 20-N (-1.8%) load (P >.50 to.62). Slightly greater changes occurred in anterior translation after posterior capsuloplasty at 10 N (-1.0%), 15 N (-6.0%), and 20 N (-10.3%). However, these changes were not found to be significant either (P =.06 to.62). The results of this study demonstrated that neither posterior nor anterior glenohumeral translation was significantly decreased by thermal capsuloplasty of the posterior capsule. Perhaps the lack of substantial collagenous material in the thin posterior capsule accounts for the inability of thermal capsuloplasty to be effective in this region.
Selecky
Mark T
MT
Kerlan Jobe-Orthopaedic Clinic, Los Angeles, Calif, USA.
Tibone
James E
JE
Yang
Bruce Y
BY
McMahon
Patrick J
PJ
Lee
Thay Q
TQ
D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena; D002102:Cadaver; D017115:Catheter Ablation / Q000379:methods*; D006801:Humans; D017746:Joint Capsule / Q000473:pathology / Q000601:surgery*; D007593:Joint Instability / Q000473:pathology / Q000601:surgery*; D016059:Range of Motion, Articular; D016896:Treatment Outcome