Here we have some information about the Electro-thermal surgery that we use to treat our patients with shoulder instability and have very promising results.
Shoulder instability is a frequently seen condition. The shoulder joint has more freedom to move than any other joint in the body but this is exactly what makes it susceptible to instability. The main structures that give stability to the shoulder are not the bones but the soft tissues. The shoulder joint capsule and the rotator cuff tendons stabilize the shoulder against movements above the normal limits. As in any other joint abnormal and extreme movements over a period of time cause cartilage damage and osteoarthritis. Impingement syndrome can be caused by shoulder instability as well.
What causes shoulder instability itself? In general there are three ways to get an unstable shoulder. The shoulder can become unstable after acute injury as an acute dislocation for instance. Repeated trauma is another main cause. Athletes such as throwers and swimmers have to implement multiple repeated movements that put a lot of stress on their shoulders. The shoulder joint capsule gets stretched and loose instead being torn as it happens in case of an acute injury. The shoulder joint becomes unstable because the capsule can not restricts abnormal movements any more. Some inherited defects of the connective tissue can be a main reason for unstable shoulder as well.
Treatment of the unstable shoulder is approaching a new phase. The traditional treatment demands open surgery. The torn capsule has to be refreshed and reattached to the bone. Tightening with stitches and folding over works in case of loose redundant capsule. These are major surgical procedures. They need big incisions and opening the joint.
A recent addition to arthroscopic treatment is Electro-Thermal Shrinkage. This has changed the way we treat unstable shoulders. The device used to do it is a little probe that is put through an arthroscopic portal in to the joint. By using radio waves the device heats the capsule tissues to about 150 degrees F. Collagen fibers of the capsule change their internal structure and literally shrink tightening up the loose tissues.
What do you think about the Thermal capsular shrinkage? We asked Dr. Frank Wilson this question and here is his answer:
"I have been treated shoulder instability for 18 years. There is not one way to
treat each patient. However some patients frustrate us more then other with their laxity.
The Vapor offers another tool to combat this difficult problem with little or no scar. The
research is now beginning to support the effectiveness of this treatment. I have been
reluctant to use lasers because of associated damage. However radio frequency or shrinkage
warping, as I call it, seems to be safe and allows immediate feedback to the surgeon. The
shoulder gains stability right on the table under TV arthroscopic surgery equipment
control. My patients are pleased so far. The pain is minimal and the results are very
gratifying. We will not know for 5 to 10 years if this is permanent."
"On January 19, 1999 I had a Thermal Capsulorraphy performed on my right
Here you can view short video about the Electro-thermal surgery. You will need Real player. If you need the most recent version of the Real player you can download one here. Just click on the images and enjoy the video.