title: Arthroscopic treatment of shoulder instability: a systematic review of capsular plication versus thermal capsulorrhaphy.
abstract: OBJECTIVE
  Shoulder instability is a common disorder of the shoulder that can result in debilitating pain and decreased function. Poorly treated cases of instability result in excessive mobility, possibly leading to labral tears and degenerative arthritis. The purpose of my systematic review was to compare the effectiveness of 2 popular arthroscopic techniques used to reduce shoulder instability: capsular plication and thermal capsulorrhaphy.
  
  
  METHODS
  Articles were retrieved from PubMed, Cochrane Library, and Ovid/MEDLINE searches using the terms capsular plication, capsular shift, capsular shrinkage, shoulder capsulorrhaphy, and treatment of shoulder instability.
  
  
  METHODS
  I sought cohort studies, case reviews, and randomized controlled trials published from 2000 through March 2013 that evaluated the outcomes of the 2 surgical procedures, which resulted in a total of 12 studies.
  
  
  METHODS
  Outcome measures were range of motion, satisfaction, and return to previous activity level.
  
  
  RESULTS
  The overall success rates of the reviewed studies were 91% for arthroscopic capsular plication and 76.5% for thermal capsulorrhaphy.
  
  
  CONCLUSIONS
  Arthroscopic capsular plication had a higher rate of success than thermal capsulorrhaphy. However, postoperative management varied more among the thermal capsulorrhaphy studies and was generally less conservative than management involving standardized capsular-plication protocols. Future authors should investigate operative techniques and postoperative management, which may help to improve thermal capsulorrhaphy outcomes.
authors.affiliation: Charlotte Sports Medicine Institute, NC.
authors.forename: Kasey
authors.initials: K
authors.lastname: Rolfes
mesh_terms: D001182:Arthroscopy / Q000379:methods*; D015331:Cohort Studies; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery; D020069:Shoulder Pain / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome
keywords: capsular shift; shoulder rehabilitation outcomes; upper extremity