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Risk Factors for Early Failure after Thermal Capsulorrhaphy

Kyle Anderson, MD^,, Russell F. Warren, MD, David W. Altchek, MD, Edward V. Craig, MD and Stephen J. O’Brien, MD

Center for Athletic Medicine, Henry Ford Health System, Detroit, Michigan, Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York

Presented at the interim meeting of the AOSSM, Orlando, Florida, March 2000.

Address correspondence and reprint requests to Kyle Anderson, MD, William Clay Ford Center for Athletic Medicine, 6525 Second Avenue, Detroit, MI, 48202

Thermal capsular shrinkage has rapidly become a common procedure for a variety of shoulder conditions usually associated with instability, although clinical data on outcomes are limited. The objective of this study was to identify risk factors for poor outcome after thermal capsulorrhaphy. Of 106 patients who underwent thermal shrinkage, 15 patients with treatment failures were identified. The mean time to failure after the procedure was 6.3 months (range, 1 to 16). Previous operations and multiple recurrent dislocations were associated with poor outcome at a highly significant level. Multidirectional instability and participation in contact sports did not attain statistical significance as risk factors. However, statistical power in these two comparisons was insufficient to exclude them as potential risk factors. A concomitant procedure at the time of thermal capsulorrhaphy was not associated with poor outcome. The data from early treatment failures can be useful in guiding patient selection for thermal capsulorrhaphy. This procedure may be of limited value for patients who have had prior operations or have a history of multiple dislocations. The data also suggest that thermal capsulorrhaphy should be used cautiously in patients with multidirectional instability or in those who are involved in contact sports.

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