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Problems Reported After Electrothermal Shoulder Stabilization
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Posted on: 11/30/1999
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Shoulder instability can cause considerable pain, decrease in motion, and a loss of function. When conservative care fails to help this problem, then surgery may be needed. Open surgical treatment is the standard operation but often leads to shoulder arthritis later.
A newer treatment method using heat to shrink and tighten the loose capsule has also been used. This electrothermal operation is called thermal capsulorrhaphy. Long-term effects of this procedure are unknown. In this study, surgeons present the poor outcome of capsulorrhaphy of one patient.
The patient was a 26-year-old woman with right shoulder pain and a history of chronic shoulder subluxation (partial dislocation). She was treated conservatively but her symptoms didn't get better or go away. Arthroscopic thermal stabilization was performed.
At first she had a major decrease in her pain and symptoms. The shoulder seemed much more stable. But 18 months later, she started having shoulder pain again. In fact, the pain was severe enough to need narcotics.
X-rays of her shoulder showed severe loss of cartilage throughout the joint. MRI identified bony cysts that weren't there before her surgery. The shoulder capsule was scarred but not torn or frayed. Conservative cae included steroid injections, pain management, strengthening and once again failed.
Despite shoulder rehab, pain and loss of function continued. A partial shoulder replacement called hemiarthroplasty was done with good results. The authors note that treatment of progressive loss of shoulder cartilage in young, active patients is a challenge. Hemiarthroplasty can provide significant long-term pain relief and improve function.
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References:
William J. Ciccone II, MD, et al. Glenohumeral Chondrolysis Following Thermal Capsulorrhaphy. In Orthopedics. February 2007. Vol. 30. No. 2. Pp. 158-160.
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