Martyn Snow1, Ihab Boutros, Lennard Funk. 1. Department of Orthopaedics, Royal Orthopaedic Hospital, Birmingham, England. snowmartyn@gmail.com
Abstract
PURPOSE: The aims of our study were to assess the overall effectiveness of arthroscopic capsular release and to determine if the addition of a posterior capsular release had any benefit, particularly in relation to internal rotation. METHODS: Forty-eight consecutive patients with primary or secondary frozen shoulder in whom conservative physiotherapy had failed were included in the study. Arthroscopic capsular release was performed in all cases. Group 1 had an anterior and inferior release only; group 2 included a posterior release. All data were collected prospectively. Constant-Murley functional scores were used to assess outcome. Overall satisfaction and patient reported outcomes were also measured. RESULTS: The mean patient age was 51 years (range, 28 to 65 years), with no difference between the 2 groups. There were 27 patients in group 1 and 21 patients in group 2. The mean follow-up was 5 months. Etiology of the frozen shoulder was primary (22), diabetic (7), post-traumatic (7), and postoperative (11). Overall across both groups, there was a highly significant improvement in Constant score (P < .001) postoperatively. A similar pattern was noted in the range of motion (P < .001). The mean satisfaction score was 7 of 10 postoperatively. The patients reported overall outcome as much better (24), better (15), the same (1), and worse (4). There was no significant difference in Constant score between the 2 groups, and no significant difference in the improvement of the range of motion, in particular internal rotation. CONCLUSIONS: We have shown an overall rapid significant improvement following arthroscopic capsular release for primary and secondary frozen shoulder. There was no significant difference in the overall outcome with the addition of a posterior release. LEVEL OF EVIDENCE: Level III, therapeutic, retrospective comparative study.
PURPOSE: The aims of our study were to assess the overall effectiveness of arthroscopic capsular release and to determine if the addition of a posterior capsular release had any benefit, particularly in relation to internal rotation. METHODS: Forty-eight consecutive patients with primary or secondary frozen shoulder in whom conservative physiotherapy had failed were included in the study. Arthroscopic capsular release was performed in all cases. Group 1 had an anterior and inferior release only; group 2 included a posterior release. All data were collected prospectively. Constant-Murley functional scores were used to assess outcome. Overall satisfaction and patient reported outcomes were also measured. RESULTS: The mean patient age was 51 years (range, 28 to 65 years), with no difference between the 2 groups. There were 27 patients in group 1 and 21 patients in group 2. The mean follow-up was 5 months. Etiology of the frozen shoulder was primary (22), diabetic (7), post-traumatic (7), and postoperative (11). Overall across both groups, there was a highly significant improvement in Constant score (P < .001) postoperatively. A similar pattern was noted in the range of motion (P < .001). The mean satisfaction score was 7 of 10 postoperatively. The patients reported overall outcome as much better (24), better (15), the same (1), and worse (4). There was no significant difference in Constant score between the 2 groups, and no significant difference in the improvement of the range of motion, in particular internal rotation. CONCLUSIONS: We have shown an overall rapid significant improvement following arthroscopic capsular release for primary and secondary frozen shoulder. There was no significant difference in the overall outcome with the addition of a posterior release. LEVEL OF EVIDENCE: Level III, therapeutic, retrospective comparative study.
Authors: Mohammad H Ebrahimzadeh; Ali Moradi; Mostafa Khalili Pour; Mohammad Hallaj Moghadam; Amir Reza Kachooei Journal: Arch Bone Jt Surg Date: 2014-09-15