抄録
Idiopathic adhesive capsulitis of the shoulder has been thought to be self-limiting and to respond well to the physical therapy. Some of them, however, fail to respond to nonoperative management and require surgical interventions. For such refractory cases, we have performed arthroscopic release of a tight portion of the capsule which is responsible for loss of motion range in specific directions.
The purpose of this study was to evaluate clinical outcomes after arthroscopic capsular release in 9 patients with refractory frozen shoulder. There were 3 men and 6 women with a mean age of 60.7 years (range 53 to 74 years). Follow-up averaged 19.2 months (range 6 to 36 months). There were no preoperative complications. Anterior or anteroinferior capsular release was performed in all patients. Posterior capsular release was not done, except for one patient with severe restriction in internal rotation.
Passive range of motion improved significantly: with mean passive elevation improving from 97 degrees preoperatively to 159 degrees postoperatively, mean abduction from 62 degrees preoperatively to 151 degrees postoperatively, and external rotation at the side from 12 degrees to 47 degrees. Internal rotation improved by mean of 4 levels. The mean preoperative JOA score of 55 improved to 95 postoperatively. There was marked improvement of the mean pain score, from 7 preoperatively to 29 postoperatively.
Arthroscopic capsular release is a safe and effective method for management of refractory adhesive capsulitis, offering pain relief and significant gain in motion.
