title: Electrothermal arthroscopic shoulder capsulorrhaphy: a minimum 2-year follow-up.
abstract: BACKGROUND
  Few studies have documented the outcomes of thermal capsulorrhaphy for shoulder instability.
  
  
  OBJECTIVE
  To examine prospective evaluate outcomes of the first 100 patients with glenohumeral instability treated with thermal capsulorrhaphy.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Between 1997 and 1999, 85 of 100 patients treated with thermal capsulorrhaphy for glenohumeral instability were available for review at 2-year minimum follow-up (average, 4 years). Fifty-one patients suffered from anterior instability; 24 had an associated Bankart lesion. Ten patients demonstrated posterior instability; 1 had an associated reverse Bankart lesion. Seventeen patients had multidirectional instability; 8 had an associated Bankart lesion. Seven patients demonstrated anterior and posterior instability without an inferior component; 2 had an associated Bankart lesion. Failures were defined as shoulders requiring revision stabilization (14) or with recurrent instability (18), recalcitrant pain (3), or stiffness (2).
  
  
  RESULTS
  Forty-eight of 85 procedures were successful, and 37 of 85 failed. For patients with anterior instability plus a Bankart lesion, 7 of 24 (26%) had failed results. For those with anterior instability without a Bankart lesion, 10 of 27 (33%) had failed results. The failure rates for posterior, multidirectional instability, and anteroposterior were 60% (6/10), 59% (10/17), and 57% (4/7), respectively. Of the 48 successes, mean preoperative American Shoulder and Elbow Surgeons score improved from 71 to 96 postoperatively, and patient satisfaction was 9.1 on a 10-point scale.
  
  
  CONCLUSIONS
  Because of the high failure rates, we now augment thermal capsulorrhaphy with capsular plication and/or rotator interval closure in cases of posterior and multidirectional instability and have lengthened the initial immobilization period to improve outcomes. Failure rates for thermal capsulorrhaphy, even with labral repairs, are high especially for shoulders with multidirectional instability and posterior instability. When procedures were successful, however, patients were very satisfied with significant improvements in American Shoulder and Elbow Surgeons scores.
authors: Steadman Hawkins Clinic of the Carolinas, Spartanburg, South Carolina, USA.
authors: Richard J
authors: RJ
authors: Hawkins
authors: Sumant G
authors: SG
authors: Krishnan
authors: Spero G
authors: SG
authors: Karas
authors: Thomas J
authors: TJ
authors: Noonan
authors: Marilee P
authors: MP
authors: Horan
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017746:Joint Capsule / Q000503:physiopathology / Q000601:surgery*; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D020127:Recovery of Function; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome