Abstract
Multidirectional instability of the shoulder can be a difficult management problem. It usually presents in adolescents and young adults with hyperlaxity of several joints. Initial management of multidirectional instability is directed at a supervised exercise program consisting of rotator cuff, deltoid, and periscapular strengthening exercises. While conservative therapy is the mainstay of treatment and often successful, a subset of patients fails to improve, and surgical intervention is necessary to effectively restore shoulder stability.
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References
Neer CR, Foster CR. Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder: a preliminary report. J Bone J Surg Am 1980; 62: 897–908.
Pollock RG, Owens JM, Flatow EL, et al. Operative results of the inferior capsular shift procedure for multidirectional instability of the shoulder. J Bone J Surg Am 2000; 82: 919–928.
Wirth MA, Groh GI, Rockwood CA. Capsulorrhaphy through an anterior approach for the treatment of atraumatic posterior glenohumeral instability with multidirectional laxity of the shoulder. J Bone J Surg Am 1998; 80: 1570–1578.
Savoie FH, Field LD. Thermal versus suture treatment of symptomatic capsular laxity. Clin Sports Med 2000; 19: 64–75.
Lyons TR, Griffith PL, Savoie FH, et al. Laser-assisted capsulorrhaphy for multidirectional instability of the shoulder. Arthroscopy 2001; 17: 25–30.
Sperling JW, Anderson K, McCarty EC, et al. Complications of thermal capsulorrhaphy. AAOS Instr Course Lect 2001; 50: 37–41.
Abrams JS. Thermal capsulorrhaphy for instability of the shoulder: concerns and applications of the heat probe. AAOS Instr Course Lect 2001; 50: 29–36.
Fanton GS. Monopolar electrothermal arthroscopy for treatment of shoulder instability in the athlete. Oper Tech Sports Med 2000; 8: 242–249.
Gryler EC, Greis PE, Burks RT, et al. Axillary nerve temperatures during radiofrequency capsulorrhaphy of the shoulder. Arthroscopy 2001; 17: 567–572.
Shaffer, BS. Tibone, JE: Arthroscopic shoulder instability surgical complications. Clin Sports Med 1999; 18: 737–767.
Fanton GS. Arthroscopic electrothermal surgery of the shoulder. Oper Tech Sports Med 1998; 6: 139–146.
Recommended Readings
Anderson K, McCarty EC, Warren RF. Thermal capsulorrhaphy: where are we today? Sports Med Arthrosc Rev 1999; 7: 117–127.
Brillhart AT. Complications of thermal energy. Oper Tech Sports Med 1998; 6: 182–184.
Foster TE, Elman M. Arthroscopic delivery systems used for thermally induced shoulder capsulorraphy. Oper Tech Sports Med 1998; 6: 126–130.
Hayashi K, Thabit G, Massa KL, et al. The effect of thermal heating on the length and histologic properties of the glenohumeral joint capsule. Am J Sports Med 1997; 25: 107–112.
Hayashi K, Hecht P, Thabit G, et al. The biologic response to laser thermal modification in an in vitro sheep model. Clin Orthop 2000; 373: 265–276.
Hecht P, Hayashi K, Cooley AJ, et al. The thermal effect of monopolar radiofrequency energy on the properties of joint capsule: an in vivo histologic study using a sheep model. Am J Sports Med 1998; 26: 808–814.
Lopez MJ, Hayashi K, Vanderby R, et al. Effects of monopolar radiofrequency energy on ovine joint capsular mechanical properties. Clin Orthop 2000; 374: 286–297.
Lu Y, Hayashi K, Edwards RB, et al. The effect of monopolar radiofrequency treatment pattern on joint capsular healing: in vitro and in vivo studies using an ovine model. Am J Sports Med 2000; 28: 711–719.
Nath S, DiMarco JP, Haines DE. Basic aspects of radiofrequency catheter ablation. J Cardiovasc Electrophysiol 1994; 5: 863–876.
Obrzut SL, Hecht P, Hayashi K, et al. The effect of radiofrequency energy on the length and temperature properties of the glenohumeral joint capsule. Arthroscopy 1998; 14: 395–400.
Pullin JG, Collier MA, Johnson LL, et al. Holmium:YAG laser-assisted capsular shift in a canine model: intraarticular pressure and histologic observations. J Shoulder Elbow Surg 1997; 6: 272–285.
Schaefer SL, Ciarelli MJ, Arnoczky SP, et al. Tissue shrinkage with the holmium yttrium aluminum garnet laser: a postoperative assessment of tissue length, stiffness, and structure. Am J Sports Med 1997; 25: 841–848.
Schulz MM, Lee TQ, Sandusky MD, et al. The healing effects on the biomcchanical properties of joint capsular tissue treated with Ho:YAG laser: an in vivo rabbit study. Arthroscopy 2001; 17: 342–347.
Thabit G. Therapeutic heat: a historical perspective. Oper Tech Sports Med 1998; 6: 118–119.
Wall MS, Deng XH, Torzilli PA, et al. Thermal modifica- tion of collagen. J Shoulder Elbow Surg 1999; 8: 339–344.
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Bradley, J.P., Sekiya, J.K., Ong, B.C., Thompson, K.R. (2003). Arthroscopic Treatment of Multidirectional Instability: Thermal Technique. In: Shoulder Arthroscopy. Springer, New York, NY. https://doi.org/10.1007/978-0-387-21689-8_13
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DOI: https://doi.org/10.1007/978-0-387-21689-8_13
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4419-2972-3
Online ISBN: 978-0-387-21689-8
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