scholarly journals Arthroscopic capsular release for adhesive capsulitis secondary to diabetes provides better functional outcome than conservative management

2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Kanishk Bansiwal ◽  
Prashant Bhavani ◽  
Bhim Singh ◽  
Ankit Goyal ◽  
Ananta K. Naik ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Conservative Management ◽  
Adhesive Capsulitis ◽  
Conservative Group ◽  
Capsular Release ◽  
Constant Murley Score ◽  
Arthroscopic Capsular Release ◽  
Group I ◽  
Release Group

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.

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
Keyword(s):  
Functional Outcome ◽  
Adhesive Capsulitis ◽  
Capsular Release ◽  
Arthroscopic Capsular Release

scholarly journals Surgical versus Nonsurgical Multimodality Treatment in an Idiopathic Frozen Shoulder: A Retrospective Study of Clinical and Functional Outcomes

2021 ◽  
Vol 10 (21) ◽  
pp. 5185
Author(s):  
Wojciech Satora ◽  
Roman Brzóska ◽  
Robert Prill ◽  
Paweł Reichert ◽  
Łukasz Oleksy ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Functional Outcomes ◽  
Corticosteroid Injection ◽  
Frozen Shoulder ◽  
Post Treatment ◽  
Capsular Release ◽  
Arthroscopic Capsular Release ◽  
Group I ◽  
And Function

This retrospective study compared the clinical and functional outcomes of patients diagnosed with an idiopathic frozen shoulder with symptom onset of a maximum of six months, treated by arthroscopic capsular release followed by corticosteroid injection and physiotherapy to patients who received only corticosteroid injection followed by physiotherapy. The patients who underwent arthroscopic capsular release, intraoperative corticosteroid injection, and physiotherapy (Group I, n = 30) or received only corticosteroids injection and physiotherapy (Group II, n = 29) were examined in terms of shoulder range of motion (ROM), pain intensity, and function before a given treatment and three, six, and twelve months later. The groups were comparable pre-treatment in terms of ROM, pain, and functional outcome. Group I had statistically and clinically significantly better ROM and function at three and six months post-treatment than Group II. Despite being statistically significant, the between-group differences at twelve-month follow-up in ROM and function were too small to be considered clinically notable. The between-group comparison of pain revealed no significant differences at any post-treatment point of time. The early arthroscopic capsular release preceding corticosteroid injection and physiotherapy seemed more effective at three- and six-month follow-up; however, it brought a comparable result to corticosteroid injection and subsequent physiotherapy at twelve months follow-up.

scholarly journals Assessment of functional outcome of operative vs conservative management of displaced clavicle fractures

2021 ◽  
Vol 7 (3) ◽  
pp. 539
Author(s):  
Harpreet Singh ◽  
Krushna Saoji ◽  
Sangam Tyagi ◽  
Dhruv Patel ◽  
Parth Patel ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Functional Outcomes ◽  
Tertiary Care ◽  
Early Mobilization ◽  
Care Hospital ◽  
Conservative Group ◽  
Constant Murley Score ◽  
Increase Rate ◽  
Clavicle Fractures

<p><strong>Background: </strong>clavicle fractures account for approximately 2.6% of all fractures. Middle third fractures account for 80% of all clavicle fractures. Historically, clavicle fractures have been treated mostly nonoperatively with clavicular brace, but due to increase rate of complications such as nonunion and malunion, clavicle fractures are now increasingly being treated surgically which results in lower rate of such complications, besides improved patient oriented outcome and early mobilization.</p><p><strong>Methods: </strong>Current study is a prospective and observational comparative study, conducted over 30 patients diagnosed with displaced clavicle fractures coming to the department of orthopaedics in a tertiary care hospital in South Rajashthan between January 2019 to June 2020. Patients were then allotted alternatively into two groups. Patients selected for conservative treatment were treated with the figure of eight clavicle brace and arm sling pouch. Patients selected for operative treatment were treated with plating. Functional outcomes were assessed using Constant and Murley score in every follow up at 3 month and 6 month; and fracture union was assessed by serial radiographs taken at sixth week, third month and sixth month.</p><p><strong>Results: </strong>Among 30 patients, 15 patients were treated conservatively and rest 15 patients were treated surgically with plating. Functional outcome at the end of third and sixth months of follow up were measured by using Constant Murley score and found significantly higher in operative group than conservative group.</p><p><strong>Conclusions:</strong> In our study, it was found that at the end of 6 month follow up, patients treated surgically with plating had better functional outcomes than conservatively treated patients as measured by Constant and Murley score. It was also seen that, the duration of union and the incidence of complications was less in the operative group as compared to the conservative group.</p><p><strong> </strong></p>

scholarly journals Clinical Outcome after Arthroscopic Capsular Release for Adhesive Capsulitis of the Shoulder

2018 ◽  
Vol 21 (3) ◽  
pp. 127-133 ◽  
Author(s):  
Jae Chul Yoo ◽  
Kyoung Hwan Koh ◽  
Min Soo Shon ◽  
Kyu Hwan Bae ◽  
Tae Kang Lim
Keyword(s):  
Glenohumeral Joint ◽  
Constant Score ◽  
Adhesive Capsulitis ◽  
Clinical Results ◽  
Subacromial Space ◽  
Capsular Release ◽  
Clinical Evaluations ◽  
Arthroscopic Capsular Release ◽  
Partial Rotator Cuff Tear

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.

scholarly journals A prospective study on causes and functional outcome of frozen shoulder

2016 ◽  
Vol 4 (1) ◽  
pp. 23
Author(s):  
Sanjeev Mahajan ◽  
Daksh Gadi ◽  
Rahul Gupta ◽  
Saurav Singla ◽  
Piyush Setia ◽  
...  
Keyword(s):  
Prospective Study ◽  
Functional Outcome ◽  
Indian Population ◽  
Glenohumeral Joint ◽  
Early Stage ◽  
Adhesive Capsulitis ◽  
Treatment Options ◽  
Frozen Shoulder ◽  
Capsular Release ◽  
Arthroscopic Capsular Release

<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>

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.

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

2019 ◽  
Vol 7 (12) ◽  
pp. 232596711988817 ◽  
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.

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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