Cartilage degeneration in Shoulder from Capsular Shrink procedure?

Triathlon Forum
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Anyone in the med field heard of this problem? I had a subluxating shoulder that I had tightened in 99. One procedure was a capsular shrinking using a laser. (Shoulder has hurt every day since the surgery and in hindsite I wish I’d have never had it done) I got another MRI the other day, and now my doc says there is basically no cartilage left, it’s bone on bone. “What?” I say. “I didn’t have that problem before.” I go into telling him about the surgery and he gets this look on his face when I mention the capsular shrinking.

He says that this is a side effect they are now discovering from capsular shrinking of the shoulder, and he was told NOT to do that procedure anymore at a conference in Colorado last year. They think the heat somehow kills off the cartilage and it degenerates pretty rapidly. Anyone else heard of this?

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Thank you for giving me an excuse to use my University’s Journal index for a reason other than my job.

Link removed - Doesn’t work

Here is the abstract of the relevant article I found.

Biomechanics of shoulder capsulorrhaphy procedures.

Ahmad CS, Wang VM, Sugalski MT, Levine WN, Bigliani LU.

Center for Shoulder, Elbow, and Sports Medicine, Department of Orthopaedic Surgery, Columbia University, 622 W. 168th Street, PH-11th Center, New York, NY 10032, USA.

Nonanatomic capsulorrhaphy procedures and reconstructions used to treat shoulder instability create mechanical alterations to the glenohumeral joint that lead to eventual arthrosis. Current capsulorrhaphy procedures have evolved toward restoring normal anatomy and have stimulated relevant anatomic research. Analysis of the subscapularis insertion has demonstrated a superior tendinous insertion and an inferior muscular insertion with the inferior glenohumeral capsule consistently located beneath the muscular insertion of the subscapularis. In addition, 2 types of inferior humeral capsular attachments have been identified. The anterior capsular insertion may bifurcate into a superior internal fold adjacent to the articular cartilage and an inferior external fold on the humeral surgical neck. Alternatively, the capsule may insert over a broad area on the surgical neck. Therefore, releasing the muscular portion of the subscapularis and both capsular folds or the entire broad capsular insertion enhances proper shifting of the capsule during laterally based capsulorrhaphy procedures. Biomechanical studies allow direct study of the different parameters involved in capsulorrhaphy procedures, and several recent studies have improved our understanding. Anterior tightening procedures such as the Putti-Platt or Magnuson-Stack procedure, as well as a tight Bankart repair, result in a loss of external rotation and maximum elevation. Furthermore, this type of operative intervention creates greater posterior joint loads and abnormal posteroinferior humeral head subluxation, leading to pain and arthrosis. Anatomic capsulorrhaphy procedures produce more normal joint mechanics. Current and future studies will evaluate new arthroscopic capsulorrhaphy techniques.

If you want the full thing, PM me and I can email you a *.pdf version

Edit: I like how I was able to find this in <3 minutes. However, when I go looking for something I need, it takes hours. Bah!