360° arthroscopic capsular release in patients with adhesive capsulitis of the glenohumeral joint – indication, surgical technique, results

2001 ◽  
Vol 9 (3) ◽  
pp. 178-186 ◽  
Author(s):  
Joerg Jerosch
2020 ◽  
pp. 175857322097717
Author(s):  
Daoud Makki ◽  
Mustafa Al-Yaseen ◽  
Fayaz Almari ◽  
Puneet Monga ◽  
Lennard Funk ◽  
...  

Background Adhesive capsulitis (frozen shoulder) is characterised by pain and loss of range of motion of the glenohumeral joint. It can be present as primary (idiopathic) or secondary to surgery, trauma or other conditions that restrict the use of the shoulder joint. Various treatment options have been adopted including physiotherapy, manipulation under anaesthetic, hydrodilatation and arthroscopic or open capsular release but the optimal form of management remains uncertain. Objectives The purpose of the study was to assess the clinical outcome of glenohumeral hydrodilatation in three cohorts of patients with different aetiologies with adhesive capsulitis. Study design & methods We carried out a retrospective study of patient who underwent hydrodilatation for adhesive capsulitis between 2013 and 2015. The procedure was performed by a specialist musculoskeletal radiologist under radiological guidance. The injection consisted of steroids, local anaesthetics and NaCl solution with a target volume around 35 mL. Our outcome measures were range of motion, and pre- and post-operative pain. Patients were divided into three groups based on the presumed cause of their stiffness: idiopathic, post-traumatic and post-surgical. Results Two hundred fifty patients were included, with a mean age of 59 years (range: 20–79). Of these, 180 had idiopathic primary adhesive capsulitis (27 were diabetic), 23 were post-traumatic, and 20 following surgical procedures. Thirty-four required further intervention following initial hydrodilatation with 8 undergoing repeat hydrodilatation, and 26 requiring arthroscopic capsular release. The diabetic group accounted for 16 capsular releases and 4 repeat procedures, while the idiopathic group accounted for 9 and 4, respectively. One patient required capsular release in the surgical group. An improvement was recorded in ROM in all groups with mean abduction improving from 59° to 110°, flexion from 50° to 120° and external rotation from 20° to 50°. With regards to pain, the majority showed an improvement from severe or moderate pain to no or mild pain. Conclusions Results show that hydrodilatation resulted in an improvement in all outcome measures, with only a small number of patients, especially those with diabetes, needing further procedures or showing no improvement in range of motion and pain. There was no difference between the post-traumatic and post-surgical groups.


2018 ◽  
Vol 21 (3) ◽  
pp. 127-133 ◽  
Author(s):  
Jae Chul Yoo ◽  
Kyoung Hwan Koh ◽  
Min Soo Shon ◽  
Kyu Hwan Bae ◽  
Tae Kang Lim

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≤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.


2016 ◽  
Vol 4 (1) ◽  
pp. 23
Author(s):  
Sanjeev Mahajan ◽  
Daksh Gadi ◽  
Rahul Gupta ◽  
Saurav Singla ◽  
Piyush Setia ◽  
...  

<p><strong>Backgroud:</strong> Frozen shoulder also called as adhesive capsulitis is a condition characterised by global limitation of humeroscapular motion resulting from contracture and loss of compliance of the glenohumeral joint capsule. Frozen shoulder is a common problem and results in frustrating debilitation for its sufferers. There can be many reasons for pain and stiffness of shoulder joint, so it is very important to differentiate between adhesive capsulitis and the other causes.</p><p><strong>Objective:</strong> The main objective of the study was to evaluate the various modes of treatment for frozen shoulder and to identify various causes and associations of frozen shoulder in Indian population. To the best of our knowledge no prospective study has been done which have compared different treatment options in patients of adhesive capsulitis in Indian population.</p><p><strong>Methods:</strong> The study was done on 75 patients which were divided into three groups, based on the mode of management i.e. conservatively with medication and physiotherapy, physiotherapy and intraarticular injection and arthroscopic capsular release. The range of movement and functional outcome was compared using Constant &amp; Murley score.</p><p><strong>Conclusion:</strong> We found that patients undergoing conservative management showed benefits of various treatment options if the condition is diagnosed at an early stage but the results convincingly prove the advantages of arthroscopic capsular release in patients with chronic painful stiff shoulder or in failed conservative treatment.</p>


2021 ◽  
Vol 85 (1) ◽  
pp. 3166-3172
Author(s):  
Elias Emhemed Yousef Alazabi ◽  
Adel Mohammad Salama ◽  
Mohmed A. Abdel Salam ◽  
Hany Mohamed Abd Elfattah Bakr

2016 ◽  
Vol 25 (9) ◽  
pp. e256-e264 ◽  
Author(s):  
Callum P. Barnes ◽  
Patrick H. Lam ◽  
George A.C. Murrell

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