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Thermal capsulorrhaphy has rapidly become a common procedure for treating shoulder conditions. It is clear from laboratory data that thermal energy can be applied to collagenous tissue to alter its structure. The biomechanical properties of this modified tissue remain unclear. Also the in vivo response to this intervention in human tissues is not well understood, particularly after the reparative phase. Clinically, the short-term results of thermal shrinkage are promising in terms of the apparent tissue response and symptom resolution. Whether there will be a lasting beneficial effect is unknown. Finally, and perhaps most importantly, it has yet to be determined which shoulder conditions and types of instability are appropriately treated with this rapidly evolving technology.