Glenohumeral volume reduction in arthroscopic shoulder reconstruction: a cadaveric analysis of suture plication and thermal capsulorrhaphy.

Abstract

The purpose of this study was to objectively assess glenohumeral volume changes after arthroscopic suture plication, arthroscopic thermal capsulorrhaphy, and combined suture and thermal treatment. Cadaveric study. Five matched pairs of cadaver shoulders were treated with either thermal capsulorrhaphy (n = 5) or arthroscopic suture plication (n = 5). The shoulders treated with plication were then treated with thermal capsulorrhaphy to form a combined treatment group (plication and thermal). Preoperative and postoperative glenohumeral volume measurements were obtained, and the techniques were statistically compared with a 1-factor analysis of variance. All 3 procedures produced marked decreases in glenohumeral capsular volume. Suture plication reduced intra-articular volume an average of 19.0%. Thermal capsulorrhaphy resulted in a mean capsular volume reduction of 33.4%. Combined treatment with suture plication and thermal capsulorrhaphy reduced glenohumeral volume an average of 41.0%. Both thermal capsulorrhaphy and the combined treatment produced significantly greater reduction in glenohumeral volume than plication alone (P <.0001). Although combined suture plication and thermal capsulorrhaphy resulted in greater reduction in capsular volume than thermal capsulorrhaphy alone, the differences were not statistically significant. Our results indicate that arthroscopic suture plication and thermal capsulorrhaphy are both effective in reducing glenohumeral intra-articular volume. Thermal capsulorrhaphy alone or in combination with suture plication led to significantly greater reduction in capsular volume when compared with isolated suture plication.