Abstract
Purpose: To evaluate the short to medium term outcome of fifty-four consecutive patients (58 shoulders) treated exclusively with radiofrequency capsular shrinkage for atraumatic instability.
Methods: Twenty-three men and thirty-one women (35 shoulders) with a mean age of twenty-four years (range, 14 to 53), who failed a 12 months course of physiotherapy. Instability was multidirectional in 26 patients (29 shoulders), antero-inferior in 24 patients (25 shoulders) and postero-inferior in 4 patients.
Results: The Rowe score improved from 33.1 to 74.1 points at thirty-two months (range, 19 to 48) (p< 0.001). Instability recurred in 20 of 58 (34.5%) shoulders. Recurrent instability was related to the type of instability (10 of 13 shoulders for voluntary instability, 10 of 33 shoulders for involuntary instability and none of 12 shoulders for instability pain, p< 0.001) and previous instability surgery (7 of 10 shoulders, p< 0.01).
Outcome was not related to the direction of instability, type of radiofrequency probe, age or ligamentous laxity. Two patients had a transient reduction in sensation in the axillary nerve distribution. 22 of 38 (57.9%) patients returned to their pre-instability level of sporting activity.
Conclusion: Radiofrequency capsular shrinkage produces satisfactory results in instability pain and in involuntary instability in patients who had no previous instability surgery.
The abstracts were prepared by David Stanley. Correspondence should be addressed to him c/o British Orthopaedic Association, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PN.
