Thermal capsulorrhaphy for isolated posterior instability of the glenohumeral joint without labral detachment

Background: Posterior instability of the glenohumeral joint is uncommon, and a minimally invasive, technically easy method of treatment with consistent results has not been reported. Hypothesis: Thermal capsulorrhaphy for posterior instability with a period of postoperative immobilization will satisfactorily reestablish shoulder stability. Study Design: Case series; Level of evidence, 4. Methods: A total of 15 shoulders (13 patients) with isolated posterior instability without labral detachment were treated with thermal capsulorrhaphy. Eleven shoulders were immobilized for 6 weeks after surgery; 14 shoulders were clinically evaluated at a mean of 36 months (range, 26-53 months) after surgery. Of these patients, 2 (3 shoulders) had declined postoperative immobilization. Results: Eleven shoulders were rated as excellent or good, and 3 experienced recurrent instability and were considered failures. The 3 failures occurred in 1 of 11 shoulders that were immobilized and 2 of 3 (in the same patient) that were not immobilized postoperatively. Conclusion: Thermal capsulorrhaphy for posterior instability of the glenohumeral joint, followed by 6 weeks of postoperative immobilization, restored glenohumeral stability in this group of patients.