Wong, J Bone Joint Surg Am 2001 - Complications of Thermal Capsulorrhaphy of the Shoulder

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Complications of Thermal Capsulorrhaphy of the Shoulder

Wong, Williams·J Bone Joint Surg Am·2001·280 citations·Cross-sectional study

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Background

The purpose of this study was to evaluate the rate of recurrence and the prevalence of complications related to the use of thermal energy for the treatment of glenohumeral instability.

Methods

A survey was conducted of all members of the American Shoulder and Elbow Surgeons, the Arthroscopy Association of North America, and the American Orthopaedic Society for Sports Medicine. The survey focused on the rate of recurrence, the number of axillary nerve injuries, and the prevalence of capsular insufficiency seen in revision surgery after thermal capsulorrhaphy of the shoulder.

Results

379 surgeons responded to the survey.
Of 236,015 shoulder procedures performed over the last 5 years, 14,277 (6%) involved the use of thermal energy (1,077 involved laser energy; 9,013, monopolar radiofrequency; and 4,187, bipolar radiofrequency) for the treatment of glenohumeral instability.
The rates of recurrent instability after laser, monopolar radiofrequency, and bipolar radiofrequency capsulorrhaphy were 8.4%, 8.3%, and 7.1%, respectively.
Of the patients with recurrent instability, 363 (21 treated with laser energy, 220 treated with monopolar radiofrequency, and 122 treated with bipolar radiofrequency) required revision surgery.
In this group of patients with revision surgery, 7 (33%) of the 21 treated primarily with laser energy, 39 (18%) of the 220 treated primarily with monopolar radiofrequency, and 25 (20%) of the 122 treated primarily with bipolar radiofrequency exhibited signs of capsular attenuation at the time of the revision.
A total of 196 patients (1.4%) (3 treated with laser energy; 133, with monopolar radiofrequency; and 60, with bipolar radiofrequency) had a postoperative axillary neuropathy; 93% of the 196 had a sensory deficit only.
Of these patients, 95% recovered completely, with the sensory deficits lasting an average of 2.3 months and the combined deficits, an average of 4 months.

Conclusions

The use of thermal energy for the treatment of shoulder instability has promising short-term results. The rates of recurrent instability are low. However, when recurrent instability occurs, capsular insufficiency may be present. Axillary nerve injury was reported in 1.4% of the patients, in most of whom it resolved spontaneously.

Copyright remains with the authors and publisher.

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Complications of Thermal Capsulorrhaphy of the Shoulder

Wong, Williams·J Bone Joint Surg Am·2001·280 citations·Cross-sectional study

|

Background

The purpose of this study was to evaluate the rate of recurrence and the prevalence of complications related to the use of thermal energy for the treatment of glenohumeral instability.

Methods

A survey was conducted of all members of the American Shoulder and Elbow Surgeons, the Arthroscopy Association of North America, and the American Orthopaedic Society for Sports Medicine. The survey focused on the rate of recurrence, the number of axillary nerve injuries, and the prevalence of capsular insufficiency seen in revision surgery after thermal capsulorrhaphy of the shoulder.

Results

379 surgeons responded to the survey.
Of 236,015 shoulder procedures performed over the last 5 years, 14,277 (6%) involved the use of thermal energy (1,077 involved laser energy; 9,013, monopolar radiofrequency; and 4,187, bipolar radiofrequency) for the treatment of glenohumeral instability.
The rates of recurrent instability after laser, monopolar radiofrequency, and bipolar radiofrequency capsulorrhaphy were 8.4%, 8.3%, and 7.1%, respectively.
Of the patients with recurrent instability, 363 (21 treated with laser energy, 220 treated with monopolar radiofrequency, and 122 treated with bipolar radiofrequency) required revision surgery.
In this group of patients with revision surgery, 7 (33%) of the 21 treated primarily with laser energy, 39 (18%) of the 220 treated primarily with monopolar radiofrequency, and 25 (20%) of the 122 treated primarily with bipolar radiofrequency exhibited signs of capsular attenuation at the time of the revision.
A total of 196 patients (1.4%) (3 treated with laser energy; 133, with monopolar radiofrequency; and 60, with bipolar radiofrequency) had a postoperative axillary neuropathy; 93% of the 196 had a sensory deficit only.
Of these patients, 95% recovered completely, with the sensory deficits lasting an average of 2.3 months and the combined deficits, an average of 4 months.

Conclusions

The use of thermal energy for the treatment of shoulder instability has promising short-term results. The rates of recurrent instability are low. However, when recurrent instability occurs, capsular insufficiency may be present. Axillary nerve injury was reported in 1.4% of the patients, in most of whom it resolved spontaneously.

Copyright remains with the authors and publisher.

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