The use of nonablative thermal energy to shrink soft-tissue collagen results in ultrastructural and mechanical changes at temperatures 60 degrees C or above. Due to this effect, the fibrils undergo shortening and shrinkage. Arthroscopic thermal capsulorrhaphy has been used in the treatment of shoulder instabilities and posterior impingement syndrome; in particular, the presence of a Bankart lesion or a superior labral anterior posterior lesion requires a labral or capsulolabral repair. Despite ease of application, thermal techniques have higher complication rates, with no proven superiority over traditional suture techniques. Further studies are required to develop the most appropriate technique for tissue shrinkage without any associated tissue destruction. The mechanical properties and long-term durability of the newly produced collagen need to be analyzed, as well.
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