Glenohumeral translation after arthroscopic thermal capsuloplasty with a radiofrequency probe☆☆☆

Abstract 

The purpose of this study was to determine whether there are changes in anterior and posterior glenohumeral translation after arthroscopic thermal capsuloplasty with a radiofrequency probe. Anteriorly directed loads of 15 N and 20 N were sequentially applied to the humerus of each of 5 cadaveric glenohumeral joints, and anterior translation on the glenoid was measured through use of a customized translation apparatus and an electromagnetic tracking device. The tests were then repeated with posteriorly directed forces, and posterior translation was measured. During testing, the glenoid was rigidly fixed and the glenohumeral joint was positioned to simulate 90 degrees of shoulder abduction and 90 degrees of external rotation. By means of the radiofrequency probe, thermal energy was then applied to the anteroinferior capsuloligamentous structures; anterior and posterior translation measurements were repeated. The results showed a significant reduction in anterior and posterior translations after thermal capsuloplasty (P < .05). Anterior translation decreased from 6.8 to 4.0 mm (a 41% decrease) with the 15-N load and from 8.6 to 4.9 mm (a 42% decrease) with the 20-N load. Posterior translation decreased from 9.3 to 5.8 mm (a 36% decrease) with the 15-N load and from 10.4 to 6.5 mm (a 35% decrease) with the 20-N load. The results of this study indicate that the radiofrequency probe can be used to decrease both anterior and posterior glenohumeral translation in vitro. The biological effect on heat-treated tissues over time needs to be studied to prove that this is a satisfactory treatment for glenohumeral instability. (J Shoulder Elbow Surg 2000;9:514-8.)