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First published on February 16, 2005, doi:10.1177/0363546504270563
This version was published on May 1, 2005
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The American Journal of Sports Medicine 33:705-711 (2005)
© 2005 American Orthopaedic Society for Sports Medicine

The Effects of Thermal Capsular Shrinkage on the Outcomes of Arthroscopic Stabilization for Primary Anterior Shoulder Instability

Shiyi Chen, MD, PhD*,{dagger}, Pieter Stijn Haen, MD{dagger}, Judie Walton, PhD{dagger} and George A. C. Murrell, MD, PhD{dagger},{ddagger}

From the * Department of Orthopaedic Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China, and {dagger} Sports Medicine and Shoulder Service, Orthopaedic Research Institute, St. George Hospital, University of New South Wales, Sydney, Australia

{ddagger} Address correspondence to George A. C. Murrell, MD, PhD, Sports Medicine and Shoulder Service, Orthopaedic Research Institute, St. George Hospital, University of New South Wales, Level 2, 4-10 South Street, Kogarah, NSW 2217, Sydney, Australia (e-mail: murrell.g{at}ori.org.au).

Background: The effectiveness of arthroscopic thermal capsulorrhaphy in the prevention of recurrent instability in primary anterior stabilization is undetermined.

Purpose: To determine if patients with recurrent anterior shoulder instability who have labral repair plus arthroscopic thermal capsulorrhaphy have better outcomes than those with labral repair alone.

Study Design: Cohort study; Level of evidence, 3.

Method: There were 72 patients who underwent arthroscopic anterior shoulder stabilization with Suretac II tacks (n = 32) during 1996 to 1999 or with Suretac II tacks plus arthroscopic radiofrequency capsular shrinkage (n = 40) from 1999 to 2002. Standardized patient-determined and examiner-determined outcome measures were obtained preoperatively and at 3, 6, 12, and 24 months postoperatively. Statistical analyses included a Kaplan-Meier analysis of time to recurrent instability.

Results: Of the 72 patients, 66 had complete follow-up, including 28 patients treated with the Suretac stabilization and 38 patients with the Suretac plus radiofrequency shrinkage, for a mean follow-up of 58 and 30 months, respectively. All patients had a Bankart lesion. Both groups had similar results with respect to patient-determined and examiner-determined outcome measures. The only adverse outcome was postoperative recurrent instability in 6 of 28 cases in the Suretac group alone and 8 of 38 cases in the Suretac-plus -shrinkage group. Most recurrent instability occurred between 6 and 24 months. Kaplan-Meier analysis for time to recurrent instability showed no differences in the rate of instability recurrence between the 2 groups.

Conclusion: Arthroscopic thermal capsulorrhaphy neither enhanced nor impaired the outcomes of arthroscopic labral repair with biodegradable tacks in patients with primary recurrent anterior shoulder instability.

Key Words: arthroscopy • anterior shoulder instability • thermal capsulorrhaphy • shoulder




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