Question:My doctor has recommended a laser heat treatment for my unstable shoulder. It's supposed to tighten everything up and keep the joint from dislocating again. Will I have to wear a sling after the operation?
Answer:It's always best to ask your surgeon what is his or her post-operative protocol. The operation you describe is most likely a procedure called thermal capsulorrhaphy.
Laser or radiofrequency energy is used on the joint capsule to shrink the collagen tissue. The effect is to "tighten up" the joint and improve stability. This type of heat treatment causes cell damage that decreases the stiffness of the capsule for the first two weeks.
If you wear a sling at all, it will be during this period of time. After two weeks, the healing pattern changes to active repair. The body tries to heal the tissue that was heated up. By the end of six weeks, basic healing has occurred. By twelve weeks the tissue has stabilized to a more normal level.
Sometimes the heat treatment is done in a grid pattern. This method tends to speed up healing. You may not need any immobilization with this approach. Your surgeon is the best one to decide what's needed based on the type of damage and amount of heat applied.
Sometimes thermal capsulorrhaphy is done along with other surgery to repair torn tendons, muscles, capsule, or cartilage. Combining surgery with capsulorrhaphy may change the post-operative treatment.Anthony Miniaci, MD, FRCSC, and Michael J. Codsi, MD. Thermal Capsulorrhaphy for the Treatment of Shoulder Instability. In The American Journal of Sports Medicine. August 2006. Vol. 34. No. 8. Pp. 1356-1363.
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