Treatment of glenohumeral subluxation using electrothermal capsulorrhaphy.
OBJECTIVE
The purpose of this study was to review the results of a relatively homogenous group of patients with glenohumeral subluxation without labral pathology who were treated with an electrothermal capsulorrhaphy procedure.


METHODS
Case series without controls.


METHODS
From 1997 to 1998, 42 patients underwent electrothermal capsulorrhaphy using a monopolar radiofrequency probe (Oratec Interventions, Menlo Park, CA). Patients with prior capsular repairs, labral pathology that required repair, or capsular avulsion injuries were excluded from the study. Thirty-one patients met the inclusion criteria. Patients had a minimum of 2 years of follow-up (mean, 25 months), and a mean age of 25 years (range, 16 to 38 years). All of the patients had previously failed conservative treatment. There were 25 patients with unidirectional anterior instability, 2 patients with unidirectional inferior instability, 1 patient with unidirectional posterior instability, and 3 patients with multidirectional instability. The patients were assessed using a modified American Shoulder and Elbow Surgeons (ASES) score that examined pain (30 points), function (60 points), and patient satisfaction (10 points). In addition, subjective stability was assessed using a 10-point scale.


RESULTS
The average modified ASES score increased to 88 points from 56 preoperatively (P < .01). The average subjective stability scale increased to 8.5 from 4.4 preoperatively (P < .01). Nineteen patients (61%) had an excellent result, 4 (13%) had a good result, 5 (16%) had a fair result, and 3 (10%) had a poor result; 22 of 26 patients who participated in sports were able to return to their preinjury level of play. The subset of patients with isolated anterior instability had results similar to the overall group. There were no instances of axillary neuritis or other neurologic injury.


CONCLUSIONS
In carefully selected patients with shoulder instability, including unidirectional anterior instability without associated labral pathology, electrothermal capsulorrhaphy was effective and had few complications.


METHODS
Level IV, case series without controls.
Wong
Kirk L
KL
Department of Orthopaedic Surgery, The Hospitals of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Getz
Charles L
CL
Yeh
George L
GL
Ramsey
Matthew
M
Iannotti
Joseph P
JP
Williams
Gerald R
GR
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods; D001265:Athletic Injuries / Q000534:rehabilitation / Q000601:surgery; D012090:Cumulative Trauma Disorders / Q000534:rehabilitation / Q000601:surgery; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007103:Immobilization; D017746:Joint Capsule / Q000601:surgery; D007593:Joint Instability / Q000209:etiology / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D000078702:Radiofrequency Therapy; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012399:Rotation; D012720:Severity of Illness Index; D012783:Shoulder Dislocation / Q000150:complications / Q000534:rehabilitation / Q000601:surgery*; D016896:Treatment Outcome