Abstract
Introduction: Thermal shrinkage has been used to reduce the volume of redundant capsule in patients with multidirectional instability. Concerns have been expressed that thermal shrinkage may char or burn the capsule compromising future attempts at surgical stabilization. The purpose of the current study was to assess whether laser assisted capsular shrinkage adversely affects the result of a subsequent open inferior capsular shift.
Patients: A prospective study of ten consecutive patients treated by open inferior capsular shift following a failed laser assisted capsular shrinkage. They were five men and five women with an average age of 29 years. Six patients had true multidirectional instability, two had antero-inferior instability with multidirectional laxity and two had postero-inferior instability with multidirectional laxity. An anterior approach was used and a humeral side capsular shift performed. The mean period of follow-up was 33 months (range, 18–47 months).
Results: According to the system of Rowe et al., nine patients had an excellent rating and one poor at final follow-up. The mean score improved from 37.5 to 94 points on the Rowe scale, from 73 to 90.0 points on the Constant score and from 1.6 to 7.6 points on a numerical satisfaction scale. The one poor result was in the only patient who had multiple attempts at open stabilization prior to laser assisted capsular shrinkage. There were no complications.
Conclusion: The results of an inferior capsular shift following failed laser assisted capsula-shrinkage are comparable with the results of a primary capsular shift for multidirectional instability.
The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.
