The use of thermal capsulorrhaphy in the treatment of multidirectional instability.

The purpose of this study is to report on our experience with thermal capsulorrhaphy in the treatment of multidirectional instability of the shoulder. Thirty-three consecutive patients (33 shoulders) with multidirectional instability were treated with arthroscopic thermal capsulorrhaphy. Twelve patients had a history of traumatic dislocation. Three patients had been previously treated with open inferior capsular shift procedures. At a mean follow-up of 36 months (range, 24-40 months), results were available for 30 patients. On the basis of the UCLA rating scale, out of a possible 35 points, the mean preoperative score was 16.7 points and postoperatively it was 30.1 points, with 3 excellent, 20 good, and 7 poor results. Twenty-three patients (76%) were returned to full activity. In our experience the majority of patients with multidirectional instability were able to return to their previous occupations in the armed forces following thermal capsulorrhaphy. More information further defining the biomechanical pathology of capsular laxity and the specific role of electrothermal shrinkage in treating shoulder instability is needed.