Additional Thermal Shrinkage in Treatment of Recurrent Traumatic Anterior Shoulder Instability |
Seung-Ki Kim, M.D.,Ph.D., In-Soo Song, M.D., Myung-Sang Moon, M.D., Ph.D., Lin Guang, M.D.* |
Joint center, Sun General Hospital, Daejeon, Korea, Jilin City Traumatic Hospital, Jilin City, China* |
만성 외상성 견관절 전방 불안정성의 치료에서 병행한 관절낭 열 수축술 |
김승기, 송인수, 문명상, 임광 |
대전 선병원 관절센터, 지린시병원* |
|
Abstract |
Purpose In the traumatic anterior shoulder instability, the laxity of joint capsule and ligament is frequently demonstrated. Although a arthroscopic procedure to address anterior instability with joint capsular redundancy have generally provided good results, its recurrence rate is higher than open procedure. By reducing the capsular redundancy, thermal shrinkage is likely to improve the outcome of arthroscopic anterior stabilization. The objective of this study was to evaluate additional thermal capsular shrinkage as a treatment of joint capsular redundancy in anterior shoulder instability. Materials and Methods: From March 1999 to June 2000, 25 shoulders of 23 patients of recurrent anterior shoulder dislocation underwent arthroscopic Bankart repair with shrinkage procedure. The mean follow up was 29 months and average age at the time of operation was 26 years. Of these patients, 20 were male and 3 were female who had been experienced the average 8 times of dislocation before operation. Thermal shrinkage alone without Bankart repair was performed in two cases who did not have Bankart lesion. The clinical result was evaluated in according to Modified Rowe Score. Results: The Modified Rowe Score was improved from preoperative 35 points to postoperative 88 points. None of cases showed recurrence of dislocation. But, in two cases, temporary sensory hypesthesia of the axillary nerve was developed and in two cases of postoperative stiffness, arthroscopic capsular release and brisement were performed. Conclusion: Additional capsular shrinkage in arthroscopic technique to address recurrent anterior shoulder instability could treat effectively the capsular redundancy. |
Key Words:
Shoulder, Instability, Thermal shrinkage |
|