Clinical outcomes of arthroscopic pan-capsular release with or without entire coracohumeral ligament release for patients with frozen shoulder

Background: We evaluated the need for arthroscopic capsular release (ACR) in refractory primary frozen shoulder (FS) by comparing clinical outcomes of patients treated with ACR and manipulation under anesthesia (MUA). Methods: We assessed patients with refractory primary FS, 54 patients (group A) who were treated with MUA and 22 patients (group B) who were treated with ACR. In group A, manipulation including a backside arm-curl maneuver was performed under interscalene brachial block. In group B, manipulation was performed only to release the inferior capsule before arthroscopic circumferential capsular release, which was carried out for the unreleased capsule after manipulation. Pain, range of shoulder motion, and American Shoulder and Elbow Society score were recorded at 1 week, 3 months, 6 months, and 1 year after surgery. We compared outcome variables between treatment groups and between diabetics and non-diabetics and also evaluated the numbers of patients receiving additional intra-articular steroid injection.Results: Outcome variables at 3 months after surgery and improvements in outcome variables did not differ between groups. Group A showed significantly better results than group B in the evaluation of pain and range of motion at 1 week. Diabetics showed comparable outcomes to non-diabetics for most variables. Eleven patients required additional steroid injections between 8 to 16 weeks after surgery: 12.2% in group A, 18.2% in group B. Additional injections were given three times more often in diabetics compared to non-diabetics.Conclusions: MUA alone can yield similar clinical outcomes to ACR in refractory FS.

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Outcomes of Arthroscopic Capsular Release in the Beach-Chair Versus Lateral Decubitus Position: A Systematic Review

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119888173 ◽

2019 ◽

Vol 7 (12) ◽

pp. 232596711988817 ◽

Cited By ~ 1

Author(s):

Darby A. Houck ◽

John W. Belk ◽

Armando F. Vidal ◽

Eric C. McCarty ◽

Jonathan T. Bravman ◽

...

Keyword(s):

Systematic Review ◽

Clinical Outcomes ◽

Cochrane Library ◽

Recurrence Rates ◽

Capsular Release ◽

Arthroscopic Capsular Release ◽

Patient Reported ◽

Lateral Decubitus ◽

Beach Chair

Background: Arthroscopic capsular release (ACR) for the treatment of adhesive capsulitis of the shoulder can be performed in either the beach-chair (BC) or lateral decubitus (LD) position. Purpose: To determine the clinical outcomes and recurrence rates after ACR in the BC versus LD position. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed by searching PubMed, Embase, and the Cochrane Library databases for studies reporting clinical outcomes of patients undergoing ACR in either the BC or LD position. All English-language literature from 1990 through 2017 reporting on clinical outcomes after ACR with a minimum 3-month follow-up were reviewed by 2 independent reviewers. Recurrence rates, range of motion (ROM) results, and patient-reported outcome (PRO) scores were collected. Study methodological quality was evaluated using the modified Coleman Methodology Score (MCMS). Results: A total of 30 studies (3 level 1 evidence, 2 level 2 evidence, 4 level 3 evidence, 21 level 4 evidence) including 665 shoulders undergoing ACR in the BC position (38.1% male; mean age, 52.0 ± 3.9 years; mean follow-up, 35.4 ± 18.4 months) and 603 shoulders in the LD position (41.8% male; mean age, 53.0 ± 2.3 years; mean follow-up, 37.2 ± 16.8 months) were included. There were no significant differences in overall mean recurrence rates between groups (BC, 2.5%; LD, 2.4%; P = .81) or in any PRO scores between groups ( P > .05). There were no significant differences in improvement in ROM between groups, including external rotation at the side (BC, 36.4°; LD, 42.8°; P = .91), forward flexion (BC, 64.4°; LD, 79.3°; P = .73), abduction (BC, 77.8°; LD, 81.5°; P = .82), or internal rotation in 90° of abduction (BC, 40.8°; LD, 45.5°; P = .70). Significantly more patients in the BC group (91.6%) underwent concomitant manipulation than in the LD group (63%) ( P < .0001). There were significantly more patients with diabetes in the LD group (22.4%) versus the BC group (9.6%) ( P < .0001). Conclusion: Low rates of recurrent shoulder stiffness and excellent improvements in ROM can be achieved after ACR in either the LD or BC position. Concomitant manipulation under anesthesia is performed more frequently in the BC position compared with the LD position.

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

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2020.11.020 ◽

2021 ◽

Author(s):

Yoshihiro Hagiwara ◽

Kenji Kanazawa ◽

Akira Ando ◽

Takuya Sekiguchi ◽

Masashi Koide ◽

...

Keyword(s):

Range Of Motion ◽

Frozen Shoulder ◽

Capsular Release

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

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-014-2936-2 ◽

2014 ◽

Vol 23 (5) ◽

pp. 1536-1541 ◽

Cited By ~ 12

Author(s):

Yoshihiro Hagiwara ◽

Hiroyuki Sugaya ◽

Norimasa Takahashi ◽

Nobuaki Kawai ◽

Akira Ando ◽

...

Keyword(s):

Steroid Injection ◽

Frozen Shoulder ◽

Capsular Release

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Early Clinical Outcomes of Manipulation under Anesthesia for Refractory Adhesive Capsulitis: Comparison with Arthroscopic Capsular Release

Clinics in Orthopedic Surgery ◽

10.4055/cios19027 ◽

2020 ◽

Vol 12 (2) ◽

pp. 217

Author(s):

Du-Han Kim ◽

Kwang-Soon Song ◽

Byung-Woo Min ◽

Ki-Choer Bae ◽

Young-Jae Lim ◽

...

Keyword(s):

Clinical Outcomes ◽

Adhesive Capsulitis ◽

Manipulation Under Anesthesia ◽

Capsular Release ◽

Arthroscopic Capsular Release ◽

Early Clinical Outcomes

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

BioMed Research International ◽

10.1155/2014/834283 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 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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Arthroscopic capsular release for idiopathic frozen shoulder with intra-articular injection and a controlled manipulation

Annals of The Royal College of Surgeons of England ◽

10.1308/003588414x13824511650452 ◽

2014 ◽

Vol 96 (1) ◽

pp. 55-60 ◽

Cited By ~ 24

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.

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