Thermal capsuloplasty of the glenohumeral joint: Technique and results of treatment

Mobility of the upper extremity is essential in everyday life. Yet a large shoulder range of motion is also partly the reason that the glenohumeral joint is the most commonly dislocated joint of the body. After such instability, successful surgical treatment requires precise repair of joint pathoanatomy. Traditional open repair techniques involve capsulolabral plication and repair of the Bankart lesion, if present, to the glenoid bone. Because arthroscopy allows intra-capsular visualization of the glenohumeral joint, new techniques were developed in hopes of improving results. Instead, arthroscopic techniques have had success rates that often were inferior to the success rates with traditional, open techniques. One reason may be technical differences that influence the adequacy of repair, but failure to restore normal capsulolabral length using the arthroscopic technique may also contribute to poor outcomes. Thermal capsuloplasty enables the surgeon to diminish capsulolabral length using an arthroscopic technique. Not only must the technique of joint pathoanatomy repair be understood, but also the parameters of the instrument used to apply the heat. Clinical outcome may be equal to that of traditional open repair techniques in treatment of some instability types. Yet concerns remain, as rates of nerve injury and difficult-to-repair soft tissue injuries after thermal capsuloplasty remain uncertain.