Thermal capsulorrhaphy (also known as thermal arthroscopy or thermal capsular shrinkage) involves the use of a specialized thermal probe that delivers nonablative heat to the joint capsule or stretched ligaments, with the goal of causing the stretched collagen fibers to shrink and shorten, and thereby stabilize the joint (Carter, 2002). This procedure is carried out by percutaneous or arthroscopic placement of a thermal catheter into the joint and can be accomplished by radiofrequency or laser energy. A thermal coagulation generator is utilized to provide the required temperature for collagen shrinkage (Fanton, 2001; Clark, 2001). Thermal shrinkage has been proposed for use in arthroscopic surgery involving various joints including, but not limited to, the shoulder, knee, hip, thumb, wrist and ankle.
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Is Arthroscopic Capsular plication better than thermal capsulorrhaphy?
Data synthesis: The overall success rates of the reviewed studies were 91% for arthroscopic capsular plication and 76.5% for thermal capsulorrhaphy. Conclusions: Arthroscopic capsular plication had a higher rate of success than thermal capsulorrhaphy.
What is thermal capsulorrhaphy and how does it work?
Thermal capsulorrhaphy purportedly increases stability of the joint. It is theorized that when heat is applied to the tissue a molecular change occurs to the structure of collagen (the chief component of connective tissue, tendons and bones) causing the length of the collagen to shrink and tighten.
What is the follow-up time for electrothermal arthroscopic shoulder capsulorrhaphy?
Hawkins RJ, Krishnan SG, Karas SG, et al. Electrothermal arthroscopic shoulder capsulorrhaphy: A minimum 2-year follow-up. Am J Sports Med. 2007;35 (9):1484-1488.
What is electrothermally-assisted capsulorrhaphy?
Electrothermally-assisted capsulorrhaphy (ETAC): A new surgical method for glenohumeral instability and its rehabilitation considerations. J Orthop Sports Phys Ther. 2000;30 (7):390-400.
What is arthroscopic Capsulorrhaphy shoulder?
A capsulorrhaphy is a surgical procedure that repairs and tightens the shoulder capsule, (the connective tissue around the shoulder) to help stabilize the ball and socket. The procedure tightens the essential ligaments that provide stability to the shoulder joint.
What is thermal Capsulorrhaphy?
Thermal capsulorrhaphy is a new treatment modality for shoulder instability, where the joint capsular tissue is heated and reduced in length by laser or radiofrequency energy to regain joint stability.
What is the arthroscopy shoulder procedure?
Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The arthroscope is inserted through a small cut (incision) in your skin.
What is a Remplissage?
Remplissage is a French term that means "To Fill the Defect". Thus in this procedure an additional pair of anchors are placed into the Hill-Sachs lesion and the infraspinatus rotator cuff tendon is repaired into the defect to fill the defect. This serves as a checkrein to prevent any further anterior instability.
What is a Bankart repair of the shoulder?
A Bankart lesion is a shoulder injury that occurs due to a labrum tear causing instability and recurrent dislocations of the shoulder joint. Arthroscopic Bankart repair is a minimally invasive surgical procedure performed to reattach and tighten the detached labrum within the shoulder joint.
What is Capsulolabral repair?
What is Capsulolabral Reconstruction? Capsulolabral reconstruction, also known as The Bankart Repair is the most common surgery performed on patients with chronic shoulder instability. The most common form of ligament injury, a Bankart lesion occurs when the ligaments are torn from the front of the shoulder socket.
How is arthroscopy used to treat injuries?
During the procedure, your doctor will insert a tool called an arthroscope into your joint through several small cuts to see how much damage is in the joint. They can also repair many injuries during arthroscopy.
What are the different types of shoulder surgery?
The 5 Most Common Types of Shoulder SurgeriesRotator cuff repair.Total shoulder replacement.Arthroscopy for frozen shoulder.Acromioclavicular joint repair for arthritis.Arthroscopy for impingement syndrome.
What is arthroscopic shoulder debridement?
Extensive Debridement Shoulder is a procedure used to remove debris and damaged tissue in the shoulder joint. This procedure is performed as minimally invasive as possible by using a very small camera called an arthroscope.
What is Remplissage repair?
Remplissage is an additional procedure, along with arthroscopic Bankart repair, that may be performed in the presence of a Hill Sachs defect to prevent humeral head engagement on the glenoid during abduction and external rotation.
What is Latarjet shoulder surgery?
The Latarjet procedure is a brilliant improvement on an operation that has been around for half a century. It is an operation to stabilise your shoulder and prevent shoulder dislocation. It involves taking a bone graft from the front of the shoulder blade and attaching it to the front of your shoulder joint socket.
What is a putti Platt procedure?
Putti-Platt is one of the surgical treatment options for anterior shoulder instability. In this procedure, the flexible cord (tendon) of the subscapularis muscle is cut and then reattached to the head of the upper arm bone (humerus).
What is thermal capsulorrhaphy?
Thermal capsulorrhaphy purportedly increases stability of the joint. It is theorized that when heat is applied to the tissue a molecular change occurs to the structure of collagen (the chief component of connective tissue, tendons and bones) causing the length of the collagen to shrink and tighten.
What is the goal of shoulder surgery?
The main goal for any shoulder surgery is to stabilize the shoulder and maintain a full, pain-free range of motion.
What is subluxation in shoulder?
Most shoulder dislocations are anterior. Subluxation is the feeling that the shoulder slips slightly out of socket, then immediately comes back in place.
What is the term for a tearing of the labrum from the glenoid rim?
Dislocations occur when the head of the humerus completely pops out of the socket, and typically are the result of a complete dislocation with capsulo-labral avulsion, a tearing away of the labrum from the glenoid rim. The first few times this happens, it is usually with significant, high-energy trauma.
Why does my shoulder capsule become unstable?
The cause of this instability varies. Sometimes it is the result of an abnormal, generalized hyperlaxity of the capsule usually caused by repetitive microtrauma, such as in overhead throwing sports, racquet sports, and swimming. It can also result from recurrent partial or full anterior dislocations of the shoulder.
Is arthroscopic wafer surgery effective for type 1A?
For type 2 injuries, the arthroscopic wafer procedure is equally effective as ulnar shortening osteotomy but is associated with fewer complications in the ulnar positive wrist.
Is electrothermal arthroscopy longer term?
Although results of short-term studies of electrothermal arthroscopy appear to equal or exceed other sur gical procedures, longer-term clinical outcome studies with direct comparisons with open procedures are necessary to determine the effectiveness of electrothermal arthroscopy.
What is thermal capsulorrhaphy?
Thermal capsulorrhaphy (also known as thermal arthroscopy or thermal capsular shrinkage) involves the use of a specialized thermal probe that delivers nonablative heat to the joint capsule or stretched ligaments, with the goal of causing the stretched collagen fibers to shrink and shorten, and thereby stabili ze the joint (Carter, 2002). This procedure is carried out by percutaneous or arthroscopic placement of a thermal catheter into the joint and can be accomplished by radiofrequency or laser energy. A thermal coagulation generator is utilized to provide the required temperature for collagen shrinkage (Fanton, 2001; Clark, 2001). Thermal shrinkage has been proposed for use in arthroscopic surgery involving various joints including, but not limited to, the shoulder, knee, hip, thumb, wrist and ankle.
When conservative methods of treatment are not effective in correcting knee stability (i.e., rest, ice,
When conservative methods of treatment are not effective in correcting knee stability (i.e., rest, ice, physical therapy), surgical intervention may be necessary to repair the lax or damaged ACL.
What is AAOS in orthopedics?
American Academy of Orthopaedic Surgeons (AAOS) An advisory statement by the American Association of Orthopaedic Surgeons® (AAOS) regarding the use of thermal modalities that long-term results of thermal capsular shrinkage are not known at this time. Thermal capsular shrinkage must be undertaken with caution. The role of thermal capsular shrinkage for the treatment of shoulder instability is still being defined. (AAOS, 2010).
Does Medicare cover thermal shrinkage?
Medicare does not have a National Coverage Determination (NCD) for thermal capsulorrhaphy/thermal shrinkage therapy for joint capsules, ligaments and tendons. Local Coverage Determinations (LCDs) do not exist at this time.
Is thermal capsulorrhaphy FDA approved?
Thermal capsulorrhaphy is a procedure, and thus, not regulated by the FDA. However, a thermal probe is used during the surgery. Several probe devices have been approved under the FDA 510(k) criteria, product code GEI and GEX. Additional information is available at:
