Leslie J Bisson1. 1. Northtowns Orthopaedics, PC 8750 Transit Road, East Amherst, NY 14051, USA. klbisson@aol.com
Abstract
BACKGROUND: Posterior instability of the glenohumeral joint is uncommon, and a minimally invasive, technically easy method of treatment with consistent results has not been reported. HYPOTHESIS: Thermal capsulorrhaphy for posterior instability with a period of postoperative immobilization will satisfactorily reestablish shoulder stability. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A total of 15 shoulders (13 patients) with isolated posterior instability without labral detachment were treated with thermal capsulorrhaphy. Eleven shoulders were immobilized for 6 weeks after surgery; 14 shoulders were clinically evaluated at a mean of 36 months (range, 26-53 months) after surgery. Of these patients, 2 (3 shoulders) had declined postoperative immobilization. RESULTS: Eleven shoulders were rated as excellent or good, and 3 experienced recurrent instability and were considered failures. The 3 failures occurred in 1 of 11 shoulders that were immobilized and 2 of 3 (in the same patient) that were not immobilized postoperatively. CONCLUSION: Thermal capsulorrhaphy for posterior instability of the glenohumeral joint, followed by 6 weeks of postoperative immobilization, restored glenohumeral stability in this group of patients.
BACKGROUND: Posterior instability of the glenohumeral joint is uncommon, and a minimally invasive, technically easy method of treatment with consistent results has not been reported. HYPOTHESIS: Thermal capsulorrhaphy for posterior instability with a period of postoperative immobilization will satisfactorily reestablish shoulder stability. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A total of 15 shoulders (13 patients) with isolated posterior instability without labral detachment were treated with thermal capsulorrhaphy. Eleven shoulders were immobilized for 6 weeks after surgery; 14 shoulders were clinically evaluated at a mean of 36 months (range, 26-53 months) after surgery. Of these patients, 2 (3 shoulders) had declined postoperative immobilization. RESULTS: Eleven shoulders were rated as excellent or good, and 3 experienced recurrent instability and were considered failures. The 3 failures occurred in 1 of 11 shoulders that were immobilized and 2 of 3 (in the same patient) that were not immobilized postoperatively. CONCLUSION: Thermal capsulorrhaphy for posterior instability of the glenohumeral joint, followed by 6 weeks of postoperative immobilization, restored glenohumeral stability in this group of patients.
Authors: Ellie A Moeller; Darby A Houck; Eric C McCarty; Adam J Seidl; Jonathan T Bravman; Armando F Vidal; Rachel M Frank Journal: Orthop J Sports Med Date: 2019-01-24