A No-cutting Edge

For an athlete, a shoulder separation can be a harrowing injury, entailing a long and, in a majority of cases, incomplete recovery. Among people who suffer a first dislocation at age 24 or younger, 85% sustain subsequent separations. Now a new technique, known as ElectroThermal Arthroscopy, promises to speed up recovery and, by altering the cellular components of ligaments, cut down on later separations.

"It's like a microwave," says orthopedic surgeon Gary Fanton, a medical consultant to the San Francisco 49ers who helped to develop the thermal technique. Unlike laser surgery, in which extreme heat is used to cut tissue, ElectroThermal Arthroscopy employs radio-frequency technology, which is less costly and safer. In a clinical study Fanton determined that the lower temperatures generated by radio frequency could, with minimal invasiveness, shrink and tighten ligaments, helping to prevent later dislocations. "We're no longer altering your pants by having you take them off and then cutting and stitching," he says. "We're saying, 'Let's shrink your pants.' "

The pants-shrinker, an eight-inch arthroscopic probe two millimeters in diameter, was developed by the Menlo Park, Calif.-based company Oratec. In a 25-minute outpatient procedure, the probe uses molecular friction to heat the damaged tissue to 65°C (149°F). The process causes collagen, the cellular material in ligaments, to contract, tightening the joint. While Fanton stresses that the procedure may not be for everyone—with torn or scarred tissue, more traditional methods may be preferable—it has been performed on more than 700 patients, athletes and nonathletes alike, with a 90% success rate. The procedure was presented at the NFL team physicians' meeting last month in San Francisco. Already five teams are using it.

One satisfied customer is Brent Jones, the 49ers' All-Pro tight end, who dislocated his left shoulder last September. One of eight NFL players to have undergone ElectroThermal Arthroscopy, Jones missed only five games—a far cry from the four months he spent out of action following open surgery on a separation of the same shoulder in college. "I started rehab in two days," says Jones. "And the amazing thing is that it's so much better than it was before."