Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Clinical Outcome after Arthroscopic Capsular Release for Adhesive Capsulitis of the Shoulder

  • Yoo, Jae Chul (Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Koh, Kyoung Hwan (Department of Orthopaedic Surgery, Ilsan-Paik Hospital, Inje University School of Medicine) ;
  • Shon, Min Soo (Department of Orthopaedic Surgery, National Medical Center) ;
  • Bae, Kyu Hwan (Department of Orthopaedic Surgery, Eulji Hospital, Eulji University School of Medicine) ;
  • Lim, Tae Kang (Department of Orthopaedic Surgery, Eulji Hospital, Eulji University School of Medicine)
  • Received : 2018.04.11
  • Accepted : 2018.07.13
  • Published : 2018.09.01
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Abstract

Background: This study was undertaken to evaluate the outcome of the arthroscopic capsular release for adhesive capsulitis of the shoulder. Methods: This study retrospectively investigated thirty shoulders in 29 patients who presented with recalcitrant adhesive capsulitis and underwent arthroscopic treatments. Other than typical findings of adhesive capsulitis, combined pathologies in the glenohumeral joint and subacromial space were evaluated by arthroscopy. Clinical evaluations were performed using the Constant's score and ranges of motion (ROM) at preoperative, 6 months postoperatively and at the final follow-up. Results: Our study included 17 women and 12 men with a mean age of 53.8 years (range, 34-74). Mean follow-up duration was 24 months (range, 12-40 months). Assessment of combined pathologies revealed that partial rotator cuff tear of less than 25% thickness, was most common (overall 83.3%; with bursal 57% and articular 23%). Subacromial synovitis and adhesion were also frequent (53.3%). The Constant score and ranges of motion significantly improved at the final follow-up, compared with preoperative levels. However, clinical results at 6 months postoperatively were found to be significantly inferior to those observed at the final follow-up ($p{\leq}0.001$ for all factors). Functional impairment was the major complaint in 59.3% patients at the 6 months follow-up. Conclusions: Although arthroscopic capsular release yielded favorable outcome at the mean 24 months follow-up, pain and motion limitations at 6-month postoperatively persisted in more than 50% of our patients. While combined pathologies were commonly encountered during arthroscopy, although their effects on surgical outcome in adhesive capsulitis remains unclear in this study.

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References

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