Dr. Roddy McGee on orthopedics: what the evidence says · JRE #945
SUBJECT: ORTHOPEDICS
Not a true/false call. Every claim is logged with its sources; read the exhibits below.
he published a paper that showed a very high rate of failure from these procedures. And so as a result of that, it's fallen out of favor. So, but it was done very frequently on lots and lots of shoulders now high rate of failure was like 40 percent
What the evidence says 01 / RECORD
The guest recalled a study finding about a 40% failure rate for thermal capsulorrhaphy, a once-popular arthroscopic technique using heat to shrink shoulder capsule tissue for instability, and attributed it to a paper by Richard Hawkins. Published literature confirms this recollection is accurate: Hawkins et al. (Am J Sports Med, 2007; 85 patients, minimum 2-year follow-up) found an overall 43.5% failure rate (37/85), rising to 57-60% for posterior, multidirectional, and combined anteroposterior instability. A separate retrospective cohort (NIH/PMC review) reported a 31% overall failure rate at a mean 39-month follow-up, with failure rates varying sharply by instability type: 80% for posterior instability versus 28% for multidirectional instability. That review also noted chondrolysis (cartilage death) as a serious complication reported with increasing frequency over time, and concluded the procedure could not be recommended for most instability patients. Overall status: well-supported, both on the approximate 40% failure figure and on the claim that the procedure fell out of favor as a result.