Fitzgerald Brian T, Watson B Thomas, Lapoint John M
Department of Orthopedics, Naval Medical Center San Diego, California 92134-1005, USA.
J Shoulder Elbow Surg. 2002 Mar-Apr;11(2):108-13. doi: 10.1067/mse.2002.121476.
The purpose of this study is to report on our experience with thermal capsulorrhaphy in the treatment of multidirectional instability of the shoulder. Thirty-three consecutive patients (33 shoulders) with multidirectional instability were treated with arthroscopic thermal capsulorrhaphy. Twelve patients had a history of traumatic dislocation. Three patients had been previously treated with open inferior capsular shift procedures. At a mean follow-up of 36 months (range, 24-40 months), results were available for 30 patients. On the basis of the UCLA rating scale, out of a possible 35 points, the mean preoperative score was 16.7 points and postoperatively it was 30.1 points, with 3 excellent, 20 good, and 7 poor results. Twenty-three patients (76%) were returned to full activity. In our experience the majority of patients with multidirectional instability were able to return to their previous occupations in the armed forces following thermal capsulorrhaphy. More information further defining the biomechanical pathology of capsular laxity and the specific role of electrothermal shrinkage in treating shoulder instability is needed.
本研究的目的是报告我们使用热囊缝合术治疗肩关节多向不稳定的经验。连续33例（33个肩关节）肩关节多向不稳定患者接受了关节镜下热囊缝合术治疗。12例患者有创伤性脱位病史。3例患者此前接受过开放性下囊移位手术。平均随访36个月（范围24 - 40个月），30例患者有结果。根据加州大学洛杉矶分校（UCLA）评分量表，满分35分，术前平均评分为16.7分，术后为30.1分，其中3例为优，20例为良，7例为差。23例患者（76%）恢复了完全活动。根据我们的经验，大多数肩关节多向不稳定患者在接受热囊缝合术后能够重返军队之前的工作岗位。需要更多信息来进一步明确关节囊松弛的生物力学病理以及电热收缩在治疗肩关节不稳定中的具体作用。
