Is Arthroscopic Release a Good Treatment Option in Adhesive Capsulitis of Shoulder Refractory to Non-Operative Treatment  : Treatment Option in Adhesive Capsulitis of Shoulder Refractory

Usman Nazir Gill; Javed Hassan Raza; Muhammad Sajid; Muhammad Amir Sohail; Junaid Khan; Khalid Ameer

doi:10.54393/pjhs.v4i12.1147

Authors

Usman Nazir Gill Department of Orthopaedics, Lahore General Hospital, Lahore, Pakistan
Javed Hassan Raza Department of Orthopaedics, Jinnah Hospital, Lahore, Pakistan
Muhammad Sajid Department of Orthopaedics, Jinnah Hospital, Lahore, Pakistan
Muhammad Amir Sohail Department of Orthopaedics, Jinnah Hospital, Lahore, Pakistan
Junaid Khan Department of Orthopaedics, Lahore General Hospital, Lahore, Pakistan
Khalid Ameer Sadiq Hospital, Sargodha, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i12.1147

Keywords:

Shoulder Arthroscopy, Adhesive Capsulitis, Rotator Interval Debridement

Abstract

Adhesive capsulitis, causing shoulder pain and limited mobility, is effectively treated with arthroscopic release preferred for its proven efficacy, minimal complications, and enhanced accessibility to the whole joint capsule. Objective: To assess the outcome of arthroscopic releases in patients suffering from adhesive capsulitis in whom non-operative treatment failed. Methods: This retrospective study was conducted at Jinnah Hospital in Lahore from 2019 to 2021, encompassing 38 shoulders that underwent surgery. Among the total cohort, 15 cases were associated with female patients, and 23 male patients. Surgical interventions were carried out with patients positioned in a beach chair orientation. The initiation of physical therapy occurred at the earliest possible juncture, and evaluation of functional outcomes was undertaken employing the UCLA criteria. Results: The mean age of the individuals included in the research cohort was 51 years, exhibiting a broad age distribution ranging from 29 to 73 years. Significant improvements in the range of motion were evident, with an average augmentation of 56.71° in abduction, 38.5° in external rotation, and an additional extension of eight vertebral levels in internal rotation. As per the UCLA scoring system, the results exhibited a notably positive profile, with 16 shoulders attaining an excellent rating (42%), 16 being categorized as good (42%), and six falling within the fair or poor category (15%). Notably, five patients encountered postoperative complications. Conclusions: Arthroscopic release demonstrated effective results in alleviating pain and improving range of motion, establishing its efficacy as a treatment for adhesive capsulitis.

References

Neviaser AS and Neviaser RJ. Adhesive capsulitis of the shoulder. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2011 Sep; 19(9): 536-42. doi: 10.5435/00124635-201109000-00004. DOI: https://doi.org/10.5435/00124635-201109000-00004

Reeves B. The natural history of the frozen shoulder syndrome. Scandinavian Journal of Rheumatology. 1975 Jan; 4(4): 193-6. doi: 10.3109/03009747509165255. DOI: https://doi.org/10.3109/03009747509165255

Grey RG. Brief Note the Natural History of" Idiopathic" Frozen Shoulder. Journal of Bone and Joint Surgery. 1978 Jun; 60(4): 564. doi: 10.2106/00004623-197860040-00030. DOI: https://doi.org/10.2106/00004623-197860040-00030

Endres NK, ElHassan B, Higgins LD, Warner JJP. The stiff shoulder. 4th edition. Philadelphia: Saunders; 2009: 1405–28. doi: 10.1016/B978-1-4160-3427-8.50035-0. DOI: https://doi.org/10.1016/B978-1-4160-3427-8.50035-0

Robinson CM, Seah KM, Chee YH, Hindle P, Murray IR. Frozen shoulder. The Journal of Bone and Joint Surgery British Volume. 2012 Jan; 94(1): 1-9. doi: 10.1302/0301-620X.94B1.27093. DOI: https://doi.org/10.1302/0301-620X.94B1.27093

Ferreira Filho AA. Capsulite adesiva. Revista Brasileira De Ortopedia. 2005; 40(10): 565–74.

Checchia SL, Fregoneze M, Miyazaki AN, Santos PD, Silva L, Ossada A et al. Tratamento da capsulite adesiva com bloqueios seriados do nervo supraescapular. Revista Brasileira De Ortopedia. 2006; 41(7): 245–52.

Lafosse L, Boyle S, Kordasiewicz B, Guttierez-Arramberi M, Fritsch B, Meller R. Arthroscopic arthrolysis for recalcitrant frozen shoulder: a lateral approach. Arthroscopy: The Journal of Arthroscopic and Related Surgery. 2012 Jul; 28(7): 916-23. doi: 10.1016/j.arthro.2011.12.014. DOI: https://doi.org/10.1016/j.arthro.2011.12.014

Warner JJ, Allen A, Marks PH, Wong P. Arthroscopic release for chronic, refractory adhesive capsulitis of the shoulder. Journal of Bone and Joint Surgery. 1996 Dec; 78(12): 1808-6. doi: 10.2106/00004623-199612000-00003. DOI: https://doi.org/10.2106/00004623-199612000-00003

Jerosch J. 360 arthroscopic capsular release in patients with adhesive capsulitis of the glenohumeral joint–indication, surgical technique, results. Knee Surgery, Sports Traumatology, Arthroscopy. 2001 May; 9: 178-86. doi: 10.1007/s001670100194. DOI: https://doi.org/10.1007/s001670100194

Harryman II DT, Matsen III FA, Sidles JA. Arthroscopic management of refractory shoulder stiffness. Arthroscopy: The Journal of Arthroscopic and Related Surgery. 1997 Apr; 13(2): 133-47. doi: 10.1016/S0749-8063(97)90146-8. DOI: https://doi.org/10.1016/S0749-8063(97)90146-8

Segmüller HE, Taylor DE, Hogan CS, Saies AD, Hayes MG. Arthroscopic treatment of adhesive capsulitis. Journal of Shoulder and Elbow Surgery. 1995 Nov; 4(6): 403-8. doi: 10.1016/S1058-2746(05)80030-8. DOI: https://doi.org/10.1016/S1058-2746(05)80030-8

Baums MH, Spahn G, Nozaki M, Steckel H, Schultz W, Klinger HM. Functional outcome and general health status in patients after arthroscopic release in adhesive capsulitis. Knee Surgery, Sports Traumatology, Arthroscopy. 2007; 15(5): 638–44. doi: 10.1007/s00167-006-0203-x. DOI: https://doi.org/10.1007/s00167-006-0203-x

Tasto JP and Elias DW. Adhesive capsulitis. Sports Medicine and Arthroscopy Review. 2007 Dec; 15(4): 216-21. doi: 10.1097/JSA.0b013e3181595c22. DOI: https://doi.org/10.1097/JSA.0b013e3181595c22

Loew M, Heichel TO, Lehner B. Intraarticular lesions in primary frozen shoulder after manipulation under general anesthesia. Journal of Shoulder and Elbow Surgery. 2005 Jan; 14(1): 16-21. doi: 10.1016/j.jse.2004.04.004. DOI: https://doi.org/10.1016/j.jse.2004.04.004

Koh KH, Kim JH, Yoo JC. Iatrogenic glenoid fracture after brisement manipulation for the stiffness of shoulder in patients with rotator cuff tear. European Journal of Orthopaedic Surgery and Traumatology. 2013 Nov; 23: 175-8. doi: 10.1007/s00590-012-1090-0. DOI: https://doi.org/10.1007/s00590-012-1090-0

Magnussen RA and Taylor DC. Glenoid fracture during manipulation under anesthesia for adhesive capsulitis: a case report. Journal of Shoulder and Elbow Surgery. 2011 Apr; 20(3): e23-6. doi: 10.1016/j.jse.2010.11.024. DOI: https://doi.org/10.1016/j.jse.2010.11.024

Ozaki JI, Nakagawa Y, Sakurai G, Tamai S. Recalcitrant chronic adhesive capsulitis of the shoulder. Role of contracture of the coracohumeral ligament and rotator interval in pathogenesis and treatment. Journal of Bone and Joint Surgery. 1989 Dec; 71(10): 1511-5. doi: 10.2106/00004623-198971100-00009. DOI: https://doi.org/10.2106/00004623-198971100-00009

Gerber C, Espinosa N, Perren TG. Arthroscopic treatment of shoulder stiffness. Clinical Orthopaedics and Related Research (1976-2007). 2001 Sep; 390: 119-28. doi: 10.1097/00003086-200109000-00014. DOI: https://doi.org/10.1097/00003086-200109000-00014

Pollock RG, Duralde XA, Flatow EL, Bigliani LU. The use of arthroscopy in the treatment of resistant frozen shoulder. Clinical Orthopaedics and Related Research®. 1994 Jul; 304: 30-6. doi: 10.1097/00003086-199407000-00007. DOI: https://doi.org/10.1097/00003086-199407000-00007

Cohen M, Amaral MV, Brandão BL, Pereira MR, Monteiro M, Motta Filho GD. Avaliação dos resultados do tratamento cirúrgico artroscópico da capsulite adesiva. Revista Brasileira de Ortopedia. 2013 May; 48: 272-7. doi: 10.1016/j.rbo.2012.08.004. DOI: https://doi.org/10.1016/j.rbo.2012.08.004

Jerosch J, Filler T, Peuker E. Which joint position puts the axillary nerve at lowest risk when performing arthroscopic capsular release in patients with adhesive capsulitis of the shoulder? Knee Surgery, Sports Traumatology, Arthroscopy. 2002 Mar; 10: 126-9. doi: 10.1007/s00167-001-0270-y. DOI: https://doi.org/10.1007/s00167-001-0270-y

Jerosch J and Aldawoudy AM. Chondrolysis of the glenohumeral joint following arthroscopic capsular release for adhesive capsu litis: a case report. Knee Surgery, Sports Traumatology, Arthroscopy. 2007 Mar; 15(3): 292-4. doi: 10.1007/s00167-006-0112-z. DOI: https://doi.org/10.1007/s00167-006-0112-z

Çınar M, Akpınar S, Derincek A, Circi E, Uysal M. Comparison of arthroscopic capsular release in diabetic and idiopathic frozen shoulder patients. Archives of Orthopaedic and Trauma Surgery. 2010 Mar; 130: 401-6. doi: 10.1007/s00402-009-0900-2. DOI: https://doi.org/10.1007/s00402-009-0900-2