Abstract
Purpose
The purpose of this study was to assess the effectiveness of arthroscopic capsular release carried out for refractory cases of both primary and secondary adhesive shoulder capsulitis that were not responsive to at least 6 months of prior conservative therapy.
Methods
Arthroscopic 360-degree capsular release was performed on 167 patients (173 shoulders) with adhesive shoulder capsulitis. Ninety-one shoulders (52.6 %) had primary and 82 shoulders (47.4 %) secondary adhesive capsulitis. The median follow-up period was 36 months (range 14–67 months).
Results
All patients were evaluated according to the constant score. Both groups (primary and secondary adhesive capsulitis) experienced a significant improvement for all ranges of motion immediately postoperative, as well as at the time of follow-up. The median preoperative constant score was 41 (range 18–61) points and increased significantly to a median of 83 (range 27–100) at the time of follow-up. In the group of primary adhesive capsulitis, median preoperative score was 42 points (range 19–58) and increased to 85 points (range 36–100) at follow-up. In the group of secondary adhesive capsulitis, the preoperative mean increased from 41 points (range 18–61) to 74 points (range 27–100) at the time of the follow-up. The constant score component for pain and the visual analogue scale (VAS) score were also significantly increased.
Conclusion
Arthroscopic capsular release in patients with primary and secondary adhesive shoulder capsulitis represents a valuable therapeutic choice with minimal complications, to effectively reduce pain and improve movement in all planes of motion.
Level of evidence
Therapeutic retrospective case series study, Level IV.
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References
Bennett WF (2000) Addressing glenohumeral stiffness while treating the painful and stiff shoulder arthroscopically. Arthrosc 16(2):142–150
Bunker TD, Anthony PP (1995) The pathology of frozen shoulder: a Dupuytren-like disease. J Bone Joint Surg Br 77(5):677–683
Castellarin G, Ricci M, Vedovi E, Vecchini E, Sembenini P, Maragon A, Vangelista A (2004) Manipulation and arthroscopy under general anesthesia and early rehabilitative treatment for frozen shoulder. Arch Phys Med Rehabil 85:1236–1240
Chen J, Chen S, Li Y, Hua Y, Li H (2010) Is the extended release of the inferior gleno-humeral ligament necessary for frozen shoulder? Arthroscopy 26:529–535
Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164
Diwan DB, Murrell GA (2005) An evaluation of the effects of the extent of capsular release and of postoperative therapy on the temporal outcomes of adhesive capsulitis. Arthroscopy 21:1105–1113
Gerber C, Espinosa N, Perren GP (2001) Arthroscopic treatment of shoulder stiffness. Clin Orthop Relat Res 390:119–128
Griesser MJ, Harris JD, Campbell JE, Jones GL (2011) Adhesive capsulitis of the shoulder: a systematic review of the effectiveness of intra-articular corticosteroid injections. J Bone Joint Surg Am 93:1727–1733
Hand C, Clipsham K, Rees JL, Carr AJ (2008) Long-term outcome of frozen shoulder. J Shoulder Elbow Surg 17:231–236
Hannafin JA, Chiaia TA (2000) Adhesive capsulitis. A treatment approach. Clin Orthop Relat Res 372:95–109
Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA (2011) Current review of adhesive capsulitis. J Shoulder Elbow Surg 20:502–514
Ide J, Takagi K (2004) Early and long-term results of arthroscopic treatment for shoulder stiffness. J Shoulder Elbow Surg 13(2):174–179
Jerosch J (2001) 360° arthroscopic capsular release in patients with adhesive capsulitis of the glenohumeral joint—indication, surgical technique, results. Knee Surg Sports Traumatol Arthrosc 9:178–186
Jerosch J, Filler TJ, Peuker ET (2002) Which joint position puts the axillary nerve at the lowest risk when performing an arthroscopic capsular release (ACR) in patients with adhesive capsulitis of the shoulder? Knee Surg Sports Traumatol Arthrosc 10:126–129
Klinger HM, Otte S, Baums MH, Haerer T (2002) Early arthroscopic release in refractory shoulder stiffness. Arch Orthop Trauma Surg 122(4):200–203
Lafosse L, Boyle S, Kordasiewicz B, Guttierez-Arramberi M, Fritsch B, Meller R (2012) Arthroscopic arthrolysis for recalcitrant frozen shoulder: a lateral approach. Arthroscopy. doi:10.1016/j.arthro.2011.12.014
Lorbach O, Kieb M, Scherf C, Seil R, Kohn D, Pape D (2010) Good results after fluoroscopic-guided intra-articular injections in the treatment of adhesive capsulitis of the shoulder. Knee Surg Sports Traumatol Arthrosc 18(10):1435–1441
Lundberg BJ (1969) The frozen shoulder. Clinical and radiographical observations. The effect of manipulation under general anesthesia. Structure and glycosaminoglycan content of the joint capsule. Local bone metabolism. Acta Orthop Scand Suppl 119:1–59
Marx RG, Malizia RW, Kenter K, Wickiewicz TL, Hannafin JA (2007) Intraarticular corticosteroid injection for the treatment of idiopathic adhesive capsulitis of the shoulder. HSS J 3(2):202–207
Massoud SN, Pearse EO, Levy O, Copeland SA (2002) Operative management of the frozen shoulder in patients with diabetes. J Shoulder Elbow Surg 11:609–613
Nago M, Mitsui Y, Gotoh M, Nakama K, Shirachi I, Higuchi F, Nagata K (2010) Hyaluronan modulates cell proliferation and mRNA expression of adhesion related procollagens and cytokines in glenohumeral synovial/capsular fibroblasts in adhesive capsulitis. J Orthop Res 28(6):726–731
Neviaser AS, Neviaser RJ (2011) Adhesive capsulitis of the shoulder. J Am Acad Orthop Surg 19:536–542
Neviaser JS (1945) Adhesive capsulitis of the shoulder. A study of the pathological findings in periarthritis of the shoulder. J Bone Joint Surg 27:211–222
Neviaser RJ, Neviaser TJ (1987) The frozen shoulder: diagnosis and management. Clin Orthop Relat Res 223:59–64
Ogilvie-Harris DJ, Biggs DJ, Fitsialos DP, MacKay M (1995) The resistant frozen shoulder. Manipulation versus arthroscopic release. Clin Orthop Relat Res 315:238–248
Omari A, Bunker TD (2001) Open surgical release for frozen shoulder: surgical findings and results of the release. J Shoulder Elbow Surg 10(4):353–357
Ovesen J, Nielsen S (1986) Anterior and posterior shoulder instability: a cadaver study. Acta Orthop Scand 57(4):324–327
Peters J, Luboldt W, Schwarz W, Jacobi V, Herzog C, Vogl TJ (2004) Extracorporeal shock wave therapy in calcific tendinitis of the shoulder. Skelet Radiol 33(12):712–718
Price MR, Tillett ED, Acland RD, Nettleton GS (2004) Determining the relationship of the axillary nerve to the shoulder joint capsule from an arthroscopic perspective. J Bone Joint Surg Am 86:2135–2142
Reeves B (1975) The natural history of the frozen shoulder syndrome. Scand J Rheumatol 4:193–196
Rodeo SA, Hannafin JA, Tom J, Warren RF, Wickiewicz TL (1997) Immunolocalization of cytokines and their receptors in adhesive capsulitis of the shoulder. J Orthop Res 15(3):427–436
Snow M, Boutros I, Funk L (2009) Posterior arthroscopic capsular release in frozen shoulder. Arthroscopy 25:19–23
Uhthoff HK, Boileau P (2007) Primary frozen shoulder: global capsular stiffness versus localized contracture. Clin Orthop Relat Res 456:79–84
Warner JJP, Allen A, Marks PH, Wong P (1997) Arthroscopic release of postoperative capsular contracture of the shoulder. J Bone Surg Am 79:1151–1158
Yoo JC, Kim JH, Ahn JH, Lee SH (2007) Arthroscopic perspective of the axillary nerve in relation to the glenoid and arm position: a cadaveric study. Arthroscopy 23:1271–1277
Zanotti RM, Kuhn JE (1997) Arthroscopic capsular release for the stiff shoulder. Description of technique and anatomic considerations. Am J Sports Med 25(3):294–298
Zuckerman JD, Rokito S (2011) Frozen shoulder: a consensus definition. J Shoulder Elbow Surg 20(2):322–325
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Jerosch, J., Nasef, N.M., Peters, O. et al. Mid-term results following arthroscopic capsular release in patients with primary and secondary adhesive shoulder capsulitis. Knee Surg Sports Traumatol Arthrosc 21, 1195–1202 (2013). https://doi.org/10.1007/s00167-012-2124-1
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DOI: https://doi.org/10.1007/s00167-012-2124-1