Abstract
The purpose of this study was to report the clinical results of surgical treatment and feature of arthroscopic observation of frozen shoulder. We operated on eighteen frozen shoulders (5 gojukata in a narrow sense,2traumatic frozen shoulder,11 rotator cuff tears, mean age: 62.4 ). Rotator cuff tears included 5 joint surface incomplete tears,2 intra tendinous tears,2 small complete tears and 2 medium tears. After arthroscopic observation we released the adhesion around the rotator cuff and release coraco-humeral ligament (14/18cases). Manipulation was needed to get the range of anterior elevation in all the cases. Cuff repair was done in cases with rotator cuff tears. Resection of the distal end of the clavicle was done in cases with the arthrosis of the acromio-clavicle joint. Clinical results were evaluated according to the JOA score. Their mean follow up period was 2.4 years. In arthroscopic observation, synovitis at the rotator interval were observed in all cases. The JOA scores improved ( gojukata in a narrow sense: 41.6-92.6 points, traumatic frozen shoulder: 48.0-92.0points, rotator cuff tears: 44.2-88.3 points) in all cases. In some cases, the shoulder ROM at follow up became worse compared to that of operation time. Accurate investigation of the cause of a contracture and treatment according to the pathogenesis in each case was necessary. Not only mobilization but also a cuff repair is needed in cases with cuff tears. It was desirable to minimize the manipulative mobilization to prevent recurrence after an operation.
