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Assessment of isolated glenohumeral range of motion in patients with adhesive capsulitis can help predict failure of conservative treatment: a pilot study

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To prospectively evaluate a cohort of patients with adhesive capsulitis and identify predictors of failure of conservative treatment in the first 2 months of therapy.

Methods

This was a single-cohort, prospective observational study that included 20 participants (13 females/7 males; median age of 51.8 years [interquartile range: 8.65]) with primary adhesive capsulitis managed conservatively and evaluated clinically every month for at least 2 years of follow-up (29 [5] months). The evaluation included stage of the disease, treatment applied, radiological findings, pain levels and range of motion (active and passive ROM in the four planes and isolated glenohumeral passive ROM in abduction [GH-ABD], external rotation [GH-ER] and internal rotation). The main outcome assessed was failure of conservative treatment defined as the need for surgery and persistent pain or CMS below 70 points at the 1-year follow-up.

Results

Seven patients (7/20, 35%) were considered to have failed conservative treatment because they required arthroscopic capsular release 5.2 (2.1) months after the initial diagnosis. Of all the clinical and epidemiological variables, absence of improvement during the first 2 months in isolated glenohumeral ROM abduction and external rotation predicted failure of conservative treatment: improvement in GH-ABD (10° or more) occurred in 10/13 patients in the conservative treatment group and in 1/7 patients in the surgery group (p = 0.017). Improvement in GH-ER (10° or more) occurred in 9/13 patients in the conservative treatment group and in 0/7 patients in the surgery group (p = 0.005).

Conclusions

Precise assessment of isolated glenohumeral ROM in patients with adhesive capsulitis can help identify patients in which conservative treatment might fail. In this study, patients who did not experience early improvements in isolated glenohumeral ROM often required surgery.

Level of evidence

III (Prospective cohort study).

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Funding

No funding was obtained to perform this study.

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Authors and Affiliations

  1. Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain

    Miguel Angel Ruiz Ibán, Susana Alonso Güemes, Raquel Ruiz Díaz, Jorge Diaz Heredia & Ignacio de Rus Aznar

  2. Department of Surgery, Medical and Social Sciences, Universidad de Alcalá de Henares, Alcalá de Henares, Madrid, Spain

    Miguel Angel Ruiz Ibán, Raquel Ruiz Díaz & Jorge Diaz Heredia

  3. Servicio de Traumatologia y Cirugia Ortopedica, Hospital Universitario de Badajoz, Badajoz, Spain

    Rafael Lorente Moreno

Authors
  1. Miguel Angel Ruiz Ibán
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  2. Susana Alonso Güemes
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  3. Raquel Ruiz Díaz
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  4. Jorge Diaz Heredia
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  5. Ignacio de Rus Aznar
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  6. Rafael Lorente Moreno
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Corresponding author

Correspondence to Miguel Angel Ruiz Ibán.

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Conflict of interest

The authors have not any Conflicts of interest related to the content of this study.

Ethical approval

The study was approved by the Clinical Investigation and Ethics Committee of the Hospital Universitario Ramoón y Cajal, Madrid, Spain (IRB approval number 114/20).

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Ruiz Ibán, M.A., Alonso Güemes, S., Ruiz Díaz, R. et al. Assessment of isolated glenohumeral range of motion in patients with adhesive capsulitis can help predict failure of conservative treatment: a pilot study. Knee Surg Sports Traumatol Arthrosc 30, 2099–2104 (2022). https://doi.org/10.1007/s00167-021-06804-4

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  • DOI: https://doi.org/10.1007/s00167-021-06804-4

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