• Clinics in Shoulder and Elbow
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• v.11 no.1
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• pp.19-23
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• 2008

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.

• Clinics in Shoulder and Elbow
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• v.24 no.3
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• pp.172-177
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• 2021

Background: This study aimed to evaluate the response rate to arthroscopic release treatment in adhesive capsulitis of the shoulder (ACS) for patients with refractory to conservative treatment. Methods: In this retrospective study, 51 patients (age mean, 49.1±5.6 years) with unilateral adherent capsule underwent arthroscopic releasing surgery for the shoulder capsule. Etiologies of the ACS in 30 patients were idiopathic: 10 patients were affected after surgery and 11 patients following trauma. The patients were evaluated in terms of shoulder function, satisfaction rate, pain intensity, and joint range of motion (ROM) based on a Constant score, a Simple Shoulder Test, the visual analog scale, and four movements, respectively. Results: The mean Constant score before surgery was 48.2±3.5 and reached 74.4±6 and 77.0±6.3 at 6 months and the final follow-up, respectively (p<0.001). The mean scores of pain intensity, a Simple Shoulder Test, and ROM showed significant improvement at all follow-ups (p<0.001). Sex, age, and diabetes did not have any significant effect on patient recovery. However, patients who experienced ACS after surgery had poorer results than others at all follow-up points. Conclusions: Arthroscopic releasing surgery of the shoulder in patients with ACS refractory to conservative treatment produces rare complications and an effective injury response. It seems that patients suffering ACS following surgery have a weaker response to the treatment.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.109-114
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• 2004

Purpose: To evaluate the clinical results and prove the effectiveness of arthroscopic capsular release in refractory adhesive capsulitis of shoulder. Materials and Methods: We preformed arthroscopic capsular refractory adhesive capsulitis that not responded by stretching execies for above 1 year. 21 cases were followed above 1 year and average follow up 3 years 1 months (1${\sim}$5 years). We checked VAS of pain, ADL of function. UCLA score which were evaluated at preoperation, postoperation 6 months, 1 years and last follow up period, and compared with each other at last follow up. Results: The VAS score improved average preoperative score 8 to average postoperative score1, the ADL score improved average preoperative score 7 to average postoperative score 26, the UCLA score improved average preoperative score 8 to average postoperative score 34. Forward elevation improved average preoperative 75 degrees to average postoperative 175 degrees, external rotatiion at side improved average preoperative 4 degrees to average postoperative 52 degrees, abduction improved average Preoperative 60 degrees to average postoperative 170 degrees, internal rotation at posterior improved preoperative thigh-lumbar 3 spinous process to postoperative 7th thoracic spinous process~9th thoracic spinous process. Conclusion: Arthroscopic capsular release in refractory adhesive capsulitis that non responsive to stretching exercise for above 1 year were effective treatment method.

• The Korean Journal of Pain
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• v.24 no.4
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• pp.205-215
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• 2011

Background: Interventional pain management (IPM) is a branch of medical science that deals with management of painful medical conditions using specially equipped X-ray machines and anatomical landmarks. Interventional physiatry is a branch of physical medicine and rehabilitation that treats painful conditions through intervention in peripheral joints, the spine, and soft tissues. Methods: A cross-sectional study was conducted using three years of hospital records (2006 to 2008) from the Physical Medicine and Rehabilitation Department at Chittagong Medical College Hospital in Bangladesh, with a view toward highlighting current interventional pain practice in a tertiary medical college hospital. Result: The maximum amount of intervention was done in degenerative peripheral joint disorders (600, 46.0%), followed by inflammatory joint diseases (300, 23.0%), soft tissue rheumatism (300, 23.0%), and radicular or referred lower back conditions (100, 8.0%). Of the peripheral joints, the knee was the most common site of intervention. Motor stimulation-guided intralesional injection of methylprednisolone into the piriformis muscle was given in 10 cases of piriformis syndrome refractory to both oral medications and therapeutic exercises. Soft tissue rheumatism of unknown etiology was most common in the form of adhesive capsulitis (90, 64.3%), and is discussed separately. Epidural steroid injection was practiced for various causes of lumbar radiculopathy, with the exception of infective discitis. Conclusion: All procedures were performed using anatomical landmarks, as there were no facilities for the C-arm/diagnostic ultrasound required for accurate and safe intervention. A dedicated IPM setup should be a requirement in all PMR departments, to provide better pain management and to reduce the burden on other specialties.