Effects of Joint Capsular Release on Range of Motion in Patients with Frozen Shoulder

2021 ◽  
Author(s):  
Yoshihiro Hagiwara ◽  
Kenji Kanazawa ◽  
Akira Ando ◽  
Takuya Sekiguchi ◽  
Masashi Koide ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Capsular Release

scholarly journals Arthroscopic capsular release for idiopathic frozen shoulder with intra-articular injection and a controlled manipulation

2014 ◽  
Vol 96 (1) ◽  
pp. 55-60 ◽  
Author(s):  
CD Smith ◽  
P Hamer ◽  
TD Bunker
Keyword(s):  
Pain Relief ◽  
Range Of Motion ◽  
Frozen Shoulder ◽  
Stage Ii ◽  
Capsular Release ◽  
Oxford Shoulder Score ◽  
Arthroscopic Capsular Release ◽  
Good Pain Relief ◽  
The Mean ◽  
Shoulder Score

INTRODUCTION The aim of this prospective study was to assess the immediate and long-term effectiveness of arthroscopic capsular release in a large cohort of patients with a precise and isolated diagnosis of stage II idiopathic frozen shoulder. METHODS All patients underwent a preoperative evaluation. Patients with secondary frozen shoulder and those with concurrent pathology at arthroscopy were excluded. This left 136 patients with a stage II arthroscopically confirmed idiopathic frozen shoulder. At each postoperative attendance, a record was made of pain, function and range of motion. At 12 months, the Oxford shoulder score was calculated, and pain and range of motion were assessed. RESULTS Fifty per cent achieved good pain relief within a week and eighty per cent within six weeks of arthroscopic capsular release. The mean preoperative visual analogue scale pain score was 6.6 and the mean postoperative score was 1.0. The mean time to achieving good pain relief was 16 days following surgery. No patient could sleep through the night prior to surgery while 90% reported having a complete night’s sleep at a mean of 12 days after surgery. The mean postoperative Oxford shoulder score was 38/48 and the mean improvement was 19.2. CONCLUSIONS This large series demonstrates that arthroscopic capsular release is a safe procedure, with rapid improvement in pain and a marked improvement in range of motion.

scholarly journals Factors Affecting the Outcomes of Arthroscopic Capsular Release for Idiopathic Adhesive Capsulitis

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711986762 ◽  
Author(s):  
Syed M. Rizvi ◽  
Ahmed J. Harisha ◽  
Patrick H. Lam ◽  
George A.C. Murrell
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Linear Regression Analysis ◽  
Frozen Shoulder ◽  
Level Of Evidence ◽  
Duration Of Symptoms ◽  
Capsular Release ◽  
Arthroscopic Capsular Release

Background: Arthroscopic capsular release has been shown to provide excellent short- and long-term outcomes in patients with idiopathic frozen shoulder. Some surgeons delay surgery in the belief that operating in the early stages of adhesive capsulitis results in a poorer prognosis. However, it is unclear which factors, particularly the stage of the disorder, affect the surgical outcome of this procedure. Hypothesis: Patients who undergo capsular release during the early symptomatic stage of idiopathic adhesive capsulitis would have less improvement in range of motion compared with those who undergo surgery at a later stage. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 189 shoulders with idiopathic adhesive capsulitis that underwent arthroscopic capsular release were evaluated. All patients completed a L’Insalata questionnaire and had their range of motion and strength tested prior to surgery and at 1, 6, and 12 weeks and 6 months post–capsular release. Post hoc, patients were grouped by whether they had symptoms lasting <10 months (shorter symptoms group; n = 131) or ≥10 months (longer symptoms group; n = 38). Multiple linear regression analysis was performed to determine which preoperative factors were independently associated with a favorable outcome. Results: Patients in the shorter symptoms group were more restricted prior to surgery than were those in the longer symptoms group (mean ± SEM: external rotation, 17° ± 2° vs 27° ± 4° [ P = .04]; abduction, 78° ± 3° vs 92° ± 6° [ P = .04]; internal rotation, S3 ± 1 vs S1 ± 1 [ P = .03]). The shorter symptoms group had greater postoperative improvement in internal rotation (from S3 ± 1 preoperatively to T12 ± 1 vertebral levels) compared with the longer symptoms cohort (from S1 ± 1 to L2 ± 1) ( P = .02). Conclusion: Patients with a frozen shoulder and a duration of symptoms <10 months made greater improvements in internal rotation and had similar final results for flexion, abduction, and external rotation following arthroscopic capsular release when compared with patients who had a longer duration of symptoms, so there is no reason to delay surgery.

Shoulder hydrodilatation for primary, post-traumatic and post-operative adhesive capsulitis

2020 ◽  
pp. 175857322097717
Author(s):  
Daoud Makki ◽  
Mustafa Al-Yaseen ◽  
Fayaz Almari ◽  
Puneet Monga ◽  
Lennard Funk ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Outcome Measures ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Capsular Release ◽  
Arthroscopic Capsular Release ◽  
Number Of Patients ◽  
Post Traumatic

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.

scholarly journals L-Shaped Arthroscopic Posterior Capsular Release in Frozen Shoulder

2021 ◽  
Vol 1 (2) ◽  
pp. 263502542110000
Author(s):  
Mohamed Gamal Morsy ◽  
Ahmed Hassan Waly ◽  
Mostafa Ashraf Galal ◽  
El Hussein Mohamed Ayman ◽  
Hisham Mohamed Gawish
Keyword(s):  
Radiofrequency Ablation ◽  
Range Of Motion ◽  
Internal Rotation ◽  
Frozen Shoulder ◽  
Axillary Nerve ◽  
Posterior Capsule ◽  
Loss Of Function ◽  
Shoulder Stiffness ◽  
Capsular Release ◽  
Infraspinatus Muscle

Background: The inadequate arthroscopic release of the tight posterior capsule in frozen shoulder may result in limited postoperative shoulder internal rotation. Indication: The purpose of this article is to describe an L-shaped arthroscopic posterior capsular release to overcome the limited internal rotation that may be encountered following the standard longitudinal technique. Operative intervention is indicated in patients with refractory shoulder stiffness with limitation of internal rotation of grade 0, +2, +4 (according to the Constant-Murley Score), after failure of conservative measures for 3 to 6 months. The technique is contraindicated if less than 3 months of physical therapy, shoulder stiffness due to osseous deformity, infection, or cuff tear arthropathy. Technique: After performing a standard anterior capsular release, the scope is shifted to the anterior portal to perform posterior capsular release by introducing the radiofrequency ablation device through the posterior portal. Posterior release begins from the glenoid level down to the 6 o’clock position until the back fibers of the infraspinatus muscle appear. Then the hook-tip part of the radiofrequency ablation device is used to perform a transverse release in the posterior capsule, starting from the beginning of the longitudinal limb. The transverse limb is performed in a stepwise manner going step-by-step laterally but ending before reaching the rotator cuff to avoid any damage of the cuff. After that, the shoulder was manipulated according to Codman technique. Results: A comparative study was performed on 43 patients with primary frozen shoulder to compare the standard longitudinal (22 patients) and L-shaped (21 patients) posterior capsular release. At the final follow-up, there was a statistically significant improvement in the internal rotation range of motion in the L-shaped group ( P < .001). There was no loss of function over time. Moreover, there were no infections, instability, or axillary nerve injury in either group. Discussion/Conclusion: Restriction of internal rotation in frozen shoulder has been attributed to posterior capsular tightness. The L-shaped arthroscopic posterior capsular release in patients with primary frozen shoulder significantly improves the postoperative internal rotation range of motion.

Effects of joint capsular release on range of motion in patients with frozen shoulder

2020 ◽  
Vol 29 (9) ◽  
pp. 1836-1842 ◽  
Author(s):  
Yoshihiro Hagiwara ◽  
Kenji Kanazawa ◽  
Akira Ando ◽  
Takuya Sekiguchi ◽  
Masashi Koide ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Capsular Release

Comparative Study of effectiveness of mobilization with movement (MWM) and End range mobilization (ERM) techniques in frozen shoulder

2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Type I ◽  
Mean Values ◽  
Functional Activities ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.

Effectiveness of arthroscopic management of idiopathic shoulder stiffness: A meta-analysis

2021 ◽  
pp. 1-8
Author(s):  
Ya-Dong Wang ◽  
Yu-Xiang Ming ◽  
Yong-Hua Pang ◽  
Wei-Nan Chen ◽  
Xu-Hua Zong ◽  
...  
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Shoulder Stiffness ◽  
Capsular Release ◽  
Shoulder Range Of Motion ◽  
Arthroscopic Capsular Release ◽  
Shoulder Range

BACKGROUND: Persisting shoulder stiffness adversely affects quality of life by causing pain and motion restrictions especially in patients with diabetes. OBJECTIVE: The aim of this study was to evaluate the outcomes of arthroscopic capsular release in patients with idiopathic shoulder stiffness. METHOD: A literature search was conducted in electronic databases and studies were selected by following precise eligibility criteria. Random-effects meta-analyses were performed to estimate the changes at latest follow-up in scores of the Constant, American Shoulder and Elbow Surgeons (ASES), and University of California at Los Angelis (UCLA) scales, Visual Analogue Scale (VAS), and shoulder range of motion. RESULTS: Nineteen studies were included. The follow-up duration was 42 months [95% confidence interval (CI): 32, 51]. Improvements in scores of the Constant, ASES, UCLA scales, and VAS were 48.3 [95% CI: 38.0, 58.6], 44.6 [95% CI: 24.6, 64.6], 19.3 [95% CI: 16.6, 22.0], and -6.1 [95% CI: -6.9, -5.4] respectively (P< 0.05 all). Improvements in the shoulder range of motion were: abduction 82.0 [95% CI: 65.0, 98.9]; forward flexion 75.9 [95% CI: 59.7, 92.1]; external rotation 43.2 [95% CI: 37.5, 49.0]; and internal rotation 25.4 [95% CI: 15.2, 35.5] degrees; P< 0.05 all). CONCLUSION: Arthroscopic capsular release effectively improves shoulder function in patients with idiopathic shoulder stiffness.

Effects of intra-articular steroid injection before pan-capsular release in patients with refractory frozen shoulder

2014 ◽  
Vol 23 (5) ◽  
pp. 1536-1541 ◽  
Author(s):  
Yoshihiro Hagiwara ◽  
Hiroyuki Sugaya ◽  
Norimasa Takahashi ◽  
Nobuaki Kawai ◽  
Akira Ando ◽  
...  
Keyword(s):  
Steroid Injection ◽  
Frozen Shoulder ◽  
Capsular Release

scholarly journals The Impact of Arthroscopic Capsular Release in Patients with Primary Frozen Shoulder on Shoulder Muscular Strength

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Michał Waszczykowski ◽  
Michał Polguj ◽  
Jarosław Fabiś
Keyword(s):  
Muscular Strength ◽  
Frozen Shoulder ◽  
Active Motion ◽  
Capsular Release ◽  
Arthroscopic Capsular Release ◽  
Limited Function ◽  
And Function ◽  
The Impact

The aim of this study was to evaluate the impact of arthroscopic capsular release in patients with primary frozen shoulder on muscular strength of nonaffected and treated shoulder after at least two-year follow-up after the surgery. The assessment included twenty-seven patients, who underwent arthroscopic capsular release due to persistent limitation of range of passive and active motion, shoulder pain, and limited function of upper limb despite 6-month conservative treatment. All the patients underwent arthroscopic superior, anteroinferior, and posterior capsular release. After at least two-year follow-up, measurement of muscular strength of abductors, flexors, and external and internal rotators of the operated and nonaffected shoulder, as well as determination of range of motion (ROM) and function (ASES) in the operated and nonaffected shoulder, was performed. Measurement of muscular strength in the patient group did not reveal statistically significant differences between operated and nonaffected shoulder. The arthroscopic capsular release does not have significant impact on the decrease in the muscular strength of the operated shoulder.

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