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http://dx.doi.org/10.5397/cise.2017.20.3.117

A Randomized Comparative Study of a Standard Anterior Capsular Release versus Inferior Extended Release for the Treatment of Shoulder Stiffness  

Alzeyadi, Ahmed Abdullah (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
Kim, Yang-Soo (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
Lee, Hyo-Jin (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
Park, Sung-Ryeoll (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
Sung, Gwang Young (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
Kim, Dong-Jin (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
Jung, Ji-Hwan (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
Kim, Jong-Ho (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
Publication Information
Clinics in Shoulder and Elbow / v.20, no.3, 2017 , pp. 117-125 More about this Journal
Abstract
Background: To compare the clinical outcomes of arthroscopic capsular release in patients with and without inferior capsular release for shoulder stiffness. Methods: Between January 2010 and December 2015, 39 patients who underwent arthroscopic capsular release for shoulder stiffness were enrolled and randomized into two groups. In group I, 19 patients underwent arthroscopic capsular release of the rotator interval and anterior capsule. In group II, 20 patients underwent arthroscopic capsular release of the anterior to inferior capsule, including the rotator interval. The American Shoulder and Elbow Surgeons score, Constant scoring system, Simple Shoulder Test, visual analogue scale for pain, and range of motion (ROM) were used for evaluation before surgery, at 3, 6, and 12 months after surgery and on the last follow-up. Results: Preoperative demographic data revealed no significant differences (p>0.05). The average follow-up was 16.07 months. Both groups showed significantly increased ROM at the last follow-up compared with preoperative (p<0.05). At the last follow-up, no statistical differences were found (p>0.05) between groups I and II in functional scores and ROM (forward flexion, p=0.91; side external rotation, p=0.17; abduction external rotation, p=0.72; internal rotation, p=0.61). But we found that group II gained more flexion compared to group I at 3 months and 6 months (p<0.05) after the surgery. Conclusions: Both techniques of capsular release are effective for stiffness shoulder. However, the extended inferior capsular release shows superiority in forward flexion over anterior capsular release alone during 6 months of follows-up (level of evidence: Level I, therapeutic randomized controlled trial).
Keywords
Shoulder; Stiffness; Frozen shoulder; Arthroscopic capsular release;
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1 Codman EA. The shoulder: rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa. Boston: T. Todd Company; 1934. 216-24.
2 Watson L, Dalziel R, Story I. Frozen shoulder: a 12-month clinical outcome trial. J Shoulder Elbow Surg. 2000;9(1):16-22.   DOI
3 Shaffer B, Tibone JE, Kerlan RK. Frozen shoulder. A long-term follow-up. J Bone Joint Surg Am. 1992;74(5):738-46.   DOI
4 Tauro JC. Stiffness and rotator cuff tears: incidence, arthroscopic findings, and treatment results. Arthroscopy. 2006;22(6):581-6.   DOI
5 Warner JJ, Allen A, Marks PH, Wong P. Arthroscopic release for chronic, refractory adhesive capsulitis of the shoulder. J Bone Joint Surg Am. 1996;78(12):1808-16.   DOI
6 Harryman DT 2nd, Matsen FA 3rd, Sidles JA. Arthroscopic management of refractory shoulder stiffness. Arthroscopy. 1997;13(2):133-47.   DOI
7 Harryman DT 2nd, Sidles JA, Harris SL, Matsen FA 3rd. The role of the rotator interval capsule in passive motion and stability of the shoulder. J Bone Joint Surg Am. 1992;74(1):53-66.   DOI
8 Ozaki J, 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. J Bone Joint Surg Am. 1989;71(10):1511-5.   DOI
9 Pearsall AW 4th, Holovacs TF, Speer KP. The intra-articular component of the subscapularis tendon: anatomic and histological correlation in reference to surgical release in patients with frozen-shoulder syndrome. Arthroscopy. 2000;16(3):236-42.   DOI
10 Massoud SN, Pearse EO, Levy O, Copeland SA. Operative management of the frozen shoulder in patients with diabetes. J Shoulder Elbow Surg. 2002;11(6):609-13.   DOI
11 Nicholson GP. Arthroscopic capsular release for stiff shoulders: effect of etiology on outcomes. Arthroscopy. 2003;19(1):40-9.   DOI
12 Ide J, Takagi K. Early and long-term results of arthroscopic treatment for shoulder stiffness. J Shoulder Elbow Surg. 2004;13(2):174-9.   DOI
13 Jerosch J. 360 degrees arthroscopic capsular release in patients with adhesive capsulitis of the glenohumeral joint: indication, surgical technique, results. Knee Surg Sports Traumatol Arthrosc. 2001;9(3):178-86.   DOI
14 Pearsall AW 4th, Osbahr DC, Speer KP. An arthroscopic technique for treating patients with frozen shoulder. Arthroscopy. 1999;15(1):2-11.   DOI
15 Snow M, Boutros I, Funk L. Posterior arthroscopic capsular release in frozen shoulder. Arthroscopy. 2009;25(1):19-23.   DOI
16 Chen SK. Arthroscopic and histologiccal findings in the idiopathic frozen shoulder. J Shoulder Elbow Surg. 1996;5(2):S26.
17 Richards RR, An KN, Bigliani LU, et al. A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg. 1994;3(6):347-52.   DOI
18 Kim YS, Lee HJ, Park IJ. Clinical outcomes do not support arthroscopic posterior capsular release in addition to anterior release for shoulder stiffness: a randomized controlled study. Am J Sports Med. 2014;42(5):1143-9.   DOI
19 Ranalletta M, Rossi LA, Zaidenberg EE, et al. Midterm outcomes after arthroscopic anteroinferior capsular release for the treatment of idiophatic adhesive capsulitis. Arthroscopy. 2017; 33(3):503-8.   DOI
20 Kim YS, Lee HJ, Park I, Im JH, Park KS, Lee SB. Are delayed operations effective for patients with rotator cuff tears and concomitant stiffness? An analysis of immediate versus delayed surgery on outcomes. Arthroscopy. 2015;31(2):197-204.   DOI
21 McNamara WJ, Lam PH, Murrell GA. The relationship between shoulder stiffness and rotator cuff healing: a study of 1,533 consecutive arthroscopic rotator cuff repairs. J Bone Joint Surg Am. 2016;98(22):1879-89.   DOI
22 Neer CS 2nd, Satterlee CC, Dalsey RM, Flatow EL. The anatomy and potential effects of contracture of the coracohumeral ligament. Clin Orthop Relat Res. 1992;(280):182-5.
23 Omari A, Bunker TD. Open surgical release for frozen shoulder: surgical findings and results of the release. J Shoulder Elbow Surg. 2001;10(4):353-7.   DOI
24 Yamaguchi K, Sethi N, Bauer GS. Postoperative pain control following arthroscopic release of adhesive capsulitis: a shortterm retrospective review study of the use of an intra-articular pain catheter. Arthroscopy. 2002;18(4):359-65.   DOI
25 Miyazaki AN, Santos PD, Silva LA, Sella GD, Carrenho L, Checchia SL. Clinical evaluation of arthroscopic treatment of shoulder adhesive capsulitis. Rev Bras Ortop. 2016;52(1):61-8.
26 Ogilvie-Harris DJ, Biggs DJ, Fitsialos DP, MacKay M. The resistant frozen shoulder. Manipulation versus arthroscopic release. Clin Orthop Relat Res. 1995;(319):238-48.
27 Codding J, Dahm DL, McCarty LP 3rd, May JH, Tucker LH, Buss DD. Arthroscopic posterior-inferior capsular release in the treatment of overhead athletes. Am J Orthop (Belle Mead NJ). 2015;44(5):223-7.