Electrothermal capsulorrhaphy in glenohumeral instability without Bankart tear.
OBJECTIVE
The purpose of this study is to review the clinical results of electrothermal capsulorrhaphy (ETC) performed on 23 patients for the treatment of glenohumeral instability at an minimum follow-up of 2 years.


METHODS
Retrospective case series.


METHODS
Twenty-six patients with symptomatic unidirectional or multidirectional glenohumeral instability without Bankart tear were treated with ETC using a radiofrequency probe. No labral repairs were performed. A standard postoperative rehabilitation protocol was followed. Patients were evaluated with respect to motion, direction of instability, need for repeat surgery, return to overhand sports, and symptoms of pain and instability using various scores.


RESULTS
Twenty-three patients were available for follow-up evaluation at an average of 30 months. The overall average ASES and Rowe scores were 84.2 and 79.3, respectively. Recurrent instability requiring an open stabilization procedure occurred in 4 patients (17%), 2 with anterior and 2 with multidirectional instability. Seven of 14 overhead athletes (50%) reported inability to return to their previous level. According to Rowe scores, overall results were 11 excellent, 5 good, 4 fair, and 3 poor. No postoperative nerve complications occurred.


CONCLUSIONS
The ETC procedure was safely performed to treat glenohumeral instability without Bankart lesions. The recurrence rate is similar to that for other arthroscopic procedures but higher than for open surgery. In the absence of Bankart tear, patients with multidirectional instability and overhand athletes may require something other than an isolated ETC procedure to address instability. Long-term results of ETC are needed to better define its surgical indications.
Enad
Jerome G
JG
Bone and Joint/Sports Medicine Institute, Naval Medical Center, Portsmouth, Virginia 23708, USA. jgenad@mar.med.navy.mil
Kharrazi
F Daniel
FD
ElAttrache
Neal S
NS
Yocum
Lewis A
LA
D000293:Adolescent; D000328:Adult; D004598:Electrosurgery / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007103:Immobilization; D007593:Joint Instability / Q000534:rehabilitation / Q000601:surgery*; D008022:Ligaments / Q000473:pathology / Q000601:surgery*; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D012783:Shoulder Dislocation / Q000534:rehabilitation / Q000601:surgery*; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery*; D013177:Sports; D016896:Treatment Outcome