The effects of thermal capsular shrinkage on the outcomes of arthroscopic stabilization for primary anterior shoulder instability.

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.