DOI QR코드

DOI QR Code

Bursoscopic Finding in Primary Adhesive Capsulitis of the Shoulder

견관절 일차성 유착성 관절낭염 환자의 견봉하 관절경 소견

  • Nam, Ki-Young (Department of Orthopaedic Surgery, Chosun University Hospital) ;
  • Moon, Young-Lae (Department of Orthopaedic Surgery, Chosun University Hospital) ;
  • Kim, Dong-Hui (Department of Orthopaedic Surgery, Chosun University Hospital)
  • 남기영 (조선대학교병원 정형외과학교실) ;
  • 문영래 (조선대학교병원 정형외과학교실) ;
  • 김동휘 (조선대학교병원 정형외과학교실)
  • Published : 2008.06.15

Abstract

Purpose: To evaluate the bursoscopic findings of refractory primary adhesive capsulitis of the shoulder and to determine the clinical correlation. Materials and Methods: Arthroscopic capsular release was performed in 21 refractory adhesive capsulitis patients who had not responded to conservative treatment. The VAS for pain, range of motion, UCLA score was checked before and after surgery, and at the last follow up. Results: Bursitis, mild friction and impingement on coracoacromial ligament, as well as adhesion were observed. The function and pain improved earlier than after simple acromiohumeral joint capsular release. Conclusion: Subacromial bursoscopy helps rule out a hidden secondary frozen shoulder or secondary changes with primary adhesion. In addition, it has the advantage of being both a treatment and procedure for making a prognosis.

목적: 비수술적 치료에 반응하지 않는 일차성 유착성 관절낭염 환자에서 견봉하 점액낭의 병변을 발견하고 임상적 의의를 파악하고자 하였다. 대상 및 방법: 유착성 관절낭염 환자 21예를 대상으로 하였으며 견봉하 점액낭 유리술을 시행하고 환자의 견관절 운동 범위의 호전 정도를 측정하였고, VAS 점수 및 UCLA 평가를 시행하였다. 결과: 발견된 병변은 점액낭염, 경도의 오구 견봉 인대의 마찰 소견, 충돌 소견 및 유착의 소견이 관찰되었으며 단순 견봉 상완 관절 유리술에 비하여 기능적, 통증의 호전 효과를 조기에 얻을 수 있음을 관찰할 수 있었다. 결론: 일차성 유착성 관절낭염 환자에서 견봉하 관절경을 시행하는 것은 숨겨진 이차성 동결견의 가능성과 이차변화를 평가하여 치료와 예후 판정에 도움이 될 것으로 보인다.

Keywords

References

  1. Baslund B, Thomsen BS, Jensen EM: Frozen shoulder: current concepts. Scandinavian Journal of Rheumatology,19: 321-325, 1990. https://doi.org/10.3109/03009749009096786
  2. Braun RM, West F, Mooney V, Nickel VL, Roper B, Caldwell C: Surgical treatment of the painful shoulder contracture in the stroke patient. J Bone Joint Surg Am, 53: 1307-1312, 1971. https://doi.org/10.2106/00004623-197153070-00006
  3. Coventry MB: Problem of the painful shoulder. JAMA, 151: 177-185, 1953.
  4. Dacre JE, Beeney N, Scott DL: Injections and physiotherapy for the painful stiff shoulder. Annals of the Rheumatic Diseases, 48: 322-325, 1989. https://doi.org/10.1136/ard.48.4.322
  5. DePalma AF: Loss of scapulohumeral motion (frozen shoulder). Ann Surg, 135: 193-204, 1952. https://doi.org/10.1097/00000658-195202000-00005
  6. Ellman H, Hanker G, Bayer M: Repair of the rotator cuff. End-result study of factors influencing reconstruction. J Bone Joint Surg Am, 68: 1136-1144, 1986. https://doi.org/10.2106/00004623-198668080-00002
  7. Hammond G, Torngerson WR, Dotter WE, Leach RE: The painful shoulder. Instructional Course Lectures. The American Academy of Orthopaedic Surgeon. St. Louise, CV Mosby Co 20: 83-100, 1971.
  8. Harryman DT 2nd, Matsen FA 3rd, Sidles JA: Arthroscopic management of refractory shoulder stiffness. Arthroscopy, 13: 133-147, 1997. https://doi.org/10.1016/S0749-8063(97)90146-8
  9. Kieras DM, Masten FA: Open release in the management of refractory frozen shoulder. Orthop Trans, 15: 801-802, 1991.
  10. Lloyd-Roberts GC, French PR: Periarthritis of the shoulder. A study of the disease and its treatment. Br Med J, 1: 1569-1571, 1959. https://doi.org/10.1136/bmj.1.5137.1569
  11. Matsen III FA, Lippitt SB, Sidles JA, Harryman II DT: Practical evaluation of management of the shoulder. Philadelphia WB Sanders: 19-109, 1994.
  12. Murnaghan JP: Adhesive capsulitis of the shoulder: current concepts and treatment. Orthopedics, 11: 153-158, 1988.
  13. Murnaghan JP: Frozen shoulder. In: Rockwood CA and Masten IIi FA eds. The Shoulder. Philadelphia WB Sanders: 837-862, 1990.
  14. Neviaser RJ, Neviaser TJ: The frozen shoulder. Diagnosis and management. Clin Orthop Relat Res, 223:59-64, 1987.
  15. Ogilvie-Harris DJ, Biggs DJ, Fitsialos DP, MacKay M: The resistant frozen shoulder. Manipulation versus arthroscopic release. Clin Orthop Relat Res, 319: 238-248, 1995.
  16. Park TS, Na JU, Kim SI, Kim TS: Arthroscopic management and manipulation of chronic idiopathic adhesive capsulitis of the shoulder. J of Korean Orthop Assoc, 36: 367-371, 2001.
  17. Reeves B: The natural history of the frozen shoulder syndrome. Scandinavian Journal of Rheumatology, 4: 193-196, 1975. https://doi.org/10.3109/03009747509165255
  18. Rhee YG: The Shoulder: Diagnosis and Treatment. 207-208, 2003.
  19. Shaffer B, Tibone JE, Kerlan RK: Frozen shoulder. A long-term follow-up. J Bone Joint Surg Am, 74: 738-746, 1992. https://doi.org/10.2106/00004623-199274050-00013
  20. Wiser HI: Painful primary frozen shoulder-mobilization under local anesthesia. Arch Phys Med Rehabil, 58: 406-408, 1977.
  21. Zucker JD, Coumo F, Rokito S: Definition and classification of frozen shoulder. A consensus approach. J Shoulder Elbows Surg, 3: 872, 1994.

Cited by

  1. Demographic and Clinical Characteristics of Primary Frozen Shoulder in a Korean Population: A Retrospective Analysis of 1,373 Cases vol.18, pp.3, 2015, https://doi.org/10.5397/cise.2015.18.3.133