Functional Outcome After Arthroscopic Capsular Release in Management of the Shoulder Adhesive Capsulitis

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
2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Kanishk Bansiwal ◽  
Prashant Bhavani ◽  
Bhim Singh ◽  
Ankit Goyal ◽  
Ananta K. Naik ◽  
...  

Objectives: Comparison of outcome of subacromial bursal resection with capsular release for adhesive capsulitis of shoulder secondary to diabetes, with conservative management. Materials and Methods: This study was conducted on 68 patients of adhesive capsulitis of shoulder secondary to diabetes. The patients were divided into two groups: Arthroscopic capsular release group (group I n 32) and Conservative management group (Group II n 36) after fulfilling inclusion/ exclusion criteria. Follow-up was done at 2, 6, 24 weeks, 6 months, 1 year, and 2 years. In addition to pre-operative measurement, at each follow-up pain was assessed by visual analog scale (VAS), range of motion (ROM) was assessed by goniometer and functional outcome was assessed by Constant-Murley score. Values obtained were filled in Excel sheet and analyzed by independent t-test, Wilcoxon Rankosin test, and Analysis of Variance test on Statistical Package for the Social Sciences software. Results: Two patients in Group I and six in Group II were lost to follow-up. There was statistically significant improvement in VAS of both groups at each follow-up, but the noticeable difference was that the patients in arthroscopic release group were pain free by 6 weeks and the pain relief was sustained till final follow-up. In contrast, though there was pain relief in conservative group but they were not completely pain free till final follow-up. There was statistically significant improvement in Constant Murley score in both groups at each follow-up but arthroscopic release group achieved near normal score by 6 months and the improvement was maintained till last follow-up. The comparison of mean and median values of ROM, between the arthroscopic capsular release group and conservative group were statistically significant (P value of 0.001) for each movement. Conclusion: The improvement in ROM, decrease in pain, and functional outcome are better in diabetic patients with adhesive capsulitis undergoing Arthroscopic capsular release than conservative management.


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>


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

2019 ◽  
Vol 6 (03) ◽  
pp. 4354-4357
Author(s):  
Luciano Andrés Rossi ◽  
Maximiliano Ranalletta

Adhesive capsulitis is characterized by chronic inflammation of the capsular subsynovial layer, which produces capsular fibrosis, contracture, and adherence of the capsule to itself and to the anatomic neck of the humerus. Physical therapy is the mainstay of treatment, regardless of stage. Based on the natural history of the disease, early corticosteroid injection has a role in shortening the overall duration of symptoms allowing patients to move faster in the stages of rehabilitation and thus return to their daily life activities more rapidly. Most patients will see complete resolution of symptoms with nonsurgical management. In cases with refractory stiffness, manipulation under anesthesia or arthroscopic capsular release may be indicated. Because of various potential risks of complications with manipulations, arthroscopic capsular release is preferred. There is a lack of high level studies comparing different techniques for capsular release. Both circumferential and limited release have proven to be effective. Regarding postoperative rehabilitation, arthroscopic release should be followed by early, diligent, and directed therapy to prevent recurrent stiffness.


2019 ◽  
Vol 7 (9) ◽  
pp. 232596711986762 ◽  
Author(s):  
Syed M. Rizvi ◽  
Ahmed J. Harisha ◽  
Patrick H. Lam ◽  
George A.C. Murrell

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.


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