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Research Cools Use of Thermal Heat Treatment for Shoulder Instability

Thermal capsulorrhaphy (TC) is a way to heat the shoulder capsule and tighten it up. Doctors at the Center for Shoulder, Elbow, and Sports Medicine at Columbia University in New York City reviewed this treatment method. They presented the basic science behind it and how it's used. Results and concerns about problems with TC were also covered.

Heating up the shoulder capsule has been around since the days of Hippocrates (400 BC). Its use has become popular again in the last 10 years. But Hippocrates used a white-hot poker for his treatment. Today's doctors use laser or radiofrequency (RF) heating. A probe is used to deliver the RF. The capsule is heated to about 65 degrees Celsius (150 degrees Fahrenheit). The collagen fibers in the capsule shrink at this temperature.

These authors reviewed studies done in the past 10 years on animals, cadavers, and athletes. The results show that heat treatment to shrink the capsule has major problems. There can be loss of cartilage and joint destruction. Nerve damage can occur. The capsule can be so damaged that it won't even hold together with stitches later.

Long-term results for TC show this treatment isn't as promising as once reported. Doctors are back to the drawing board looking for better ways to treat shoulder instability.

References: William N. Levine, MD, et al. Thermal Capsulorrhaphy. In Orthopedics. August 2004. Vol. 27. No. 8. Pp. 823-826.

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