Arthroscopic Capsulorraphy for Recurrent Instability in the Athlete

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Summary:Monopolar radiofrequency energy is increasingly being used in the treatment of shoulder instability. Basic science studies have shown that thermal energy application results in structural changes in the collagen of the capsular tissue that translates to shrinkage of the capsule. The resulting shrinkage effect is useful in treating certain traumatic and recurrent instability conditions of the shoulder. This procedure has shown considerable promise as a treatment alternative in athletes and patients with recurrent instability. Range of motion is preserved, recovery is faster than with open procedures, and there is little disruption or alteration of inherent anatomy. The procedure is technically easy to perform and the complication rate is low. Clinical results at 2 years appear to equal or exceed other surgical procedures in high-demand populations. Success, however, depends on proper patient selection, attention to the rehabilitation program, and patient compliance. Long-term follow-up will be necessary to determine if results for this procedure will deteriorate over time, especially in patients with multidirectional instability.

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