Arthroscopic 360° Capsular Release for Adhesive Capsulitis in the Lateral Decubitus Position

Cvetanovich, Gregory L.; Leroux, Timothy; Hamamoto, Jason T.; Higgins, John D.; Romeo, Anthony A.; Verma, Nikhil N.

doi:10.1016/j.eats.2016.05.007

Cited by 10 publications

(25 citation statements)

References 17 publications

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“…Additionally, increased visualization of the inferior capsule when performing arthroscopic shoulder stabilization in the LD position may be advantageous in patients with 360° labral tears. 12,37 Furthermore, surgeon familiarity with the procedure and skilled technique likely contribute significantly to positive outcomes. 15…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Arthroscopic Posterior Shoulder Stabilization in the Beach-Chair Versus Lateral Decubitus Position: A Systematic Review

Moeller

Houck

McCarty

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background:Arthroscopic posterior shoulder stabilization can be performed with patients in the beach-chair (BC) and the lateral decubitus (LD) positions; however, the impact of patient positioning on clinical outcomes has not been evaluated.Purpose:To compare clinical outcomes and recurrence rates after arthroscopic posterior shoulder stabilization performed in the BC and LD positions.Study Design:Systematic review; Level of evidence, 4.Methods:A systematic review using PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines was performed by searching PubMed, Embase, and the Cochrane Library for studies reporting the clinical outcomes of patients undergoing arthroscopic posterior shoulder stabilization in either the BC or LD position. All English-language studies from 1990 to 2017 reporting clinical outcomes after arthroscopic posterior shoulder stabilization with a minimum 2-year follow-up were reviewed by 2 independent reviewers. Data on the recurrent instability rate, return to activity or sport, range of motion, and patient-reported outcome scores were collected. Study methodological quality was evaluated using the Modified Coleman Methodology Score (MCMS) and Quality Appraisal Tool (QAT).Results:A total of 15 studies (11 LD, 4 BC) with 731 shoulders met the inclusion criteria, including 626 shoulders in the LD position (mean patient age, 23.9 ± 4.1 years; mean follow-up, 37.5 ± 10.0 months) and 105 shoulders in the BC position (mean patient age, 27.8 ± 2.2 years; mean follow-up, 37.9 ± 16.6 months). There was no significant difference in the overall mean recurrent instability rate between the LD and BC groups (4.9% ± 3.6% vs 4.4% ± 5.1%, respectively; P = .83), with similar results in a subanalysis of studies utilizing only suture anchor fixation (4.9% ± 3.6% vs 3.2% ± 5.6%, respectively; P = .54). There was no significant difference in the return-to-sport rate between the BC and LD groups (96.2% ± 5.4% vs 88.6% ± 9.1%, respectively; P = .30). Range of motion and other patient-reported outcome scores were not provided consistently across studies to allow for statistical comparisons.Conclusion:Low rates of recurrent shoulder instability and high rates of return to sport can be achieved after arthroscopic posterior shoulder stabilization in either the LD or the BC position. Additional long-term randomized trials comparing these positions are needed to better understand the potential advantages and disadvantages of surgical positioning for posterior shoulder stabilization.

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Section: Discussionmentioning

confidence: 99%

Outcomes of Arthroscopic Posterior Shoulder Stabilization in the Beach-Chair Versus Lateral Decubitus Position: A Systematic Review

Moeller

Houck

McCarty

et al. 2019

Orthopaedic Journal of Sports Medicine

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“…3 Arthroscopic capsular release has been described previously for patients with frozen shoulder who are recalcitrant to non-surgical management. [4][5][6][7][8][9][10][11][12][13] Compared to manipulation under anaesthesia which carries a risk of iatrogenic fracture, arthroscopic capsular release allows for a controlled release of a tight glenohumeral joint capsule and can be combined with a selective manipulation. 14 Ogilvie-Harris and Myerthall in 1997 reported good outcomes in their series of 17 patients who underwent arthroscopic capsular release for the diabetic frozen shoulder.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of arthroscopic capsular release for the diabetic frozen shoulder in Asian patients

Puah

Salieh

Yeo

et al. 2018

J Orthop Surg (Hong Kong)

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“…Furthermore, capsular release involves the precise release of thickened capsular tissue, allowing for rapid short-term improvements in range of motion and pain reduction. 7 , 8 Bhargav and Murrell 4 reported that after capsular release, the severity of pain at rest decreases from moderate to mild and that range of motion in forward flexion increases from 70° to 100° by 1 week after surgery. Moreover, patients undergoing capsular release are encouraged to start using their shoulder as soon as possible after surgery, 22 perhaps aiding in return to sport and the confidence to do so to a higher level within the 6-month follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Return to Sport at 6 Months After Shoulder Surgery

Weber

Paraparan

Lam

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background:Many surgical procedures are intended to return patients to sport early, but it is unknown how realistic these expectations are after shoulder surgery.Purpose:To determine which of the commonly performed surgical interventions in the shoulder best facilitated return to sport, and which did not, by 6 months postoperatively.Study Design:Cohort study; Level of evidence, 3.Methods:The study was a retrospective analysis of prospectively collected data from patients who underwent shoulder surgery from a single surgeon over 12 years. To be included, at least 20 patients needed to have undergone that procedure and complete a questionnaire evaluating their shoulder’s function preoperatively and 6 months postoperatively. The primary outcome was a change in the response to the question, “What is your current level of sport?”Results:A total of 2261 surgical procedures in 13 categories met the inclusion criteria. Capsular release was the only procedure associated with improved patient-reported sporting level at 6 months (d = 0.18 [95% CI, 0.05-0.30]; P = .009). This represented a mean improvement of 41% from the preoperative sporting level. Bankart repair was associated with the greatest decrease in patient-reported sporting level at 6 months (mean decline of 21%) (d = –0.17 [95% CI, –0.34 to –0.01]; P = .034), followed by rotator cuff repair (mean decline of 13%) (d = –0.06 [95% CI, –0.03 to –0.10]; P = .0004). There were no significant changes in sporting level at 6 months postoperatively for rotator cuff repair with acromioplasty, polytetrafluoroethylene (PTFE) patch repair, acromioplasty, superior labral anterior to posterior (SLAP) repair, total shoulder arthroplasty, reverse total shoulder arthroplasty, rotator cuff repair with capsular release, rotator cuff repair with stabilization, calcific debridement, or hemiarthroplasty.Conclusion:Capsular release was the only surgical procedure that provided a significant improvement in patient-reported sporting level in a relatively short period of time (6 months). Patients who underwent rotator cuff repair and Bankart repair were the only surgical groups that reported a significant decline in sporting level 6 months postoperatively.

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Arthroscopic 360° Capsular Release for Adhesive Capsulitis in the Lateral Decubitus Position

Cited by 10 publications

References 17 publications

Outcomes of Arthroscopic Posterior Shoulder Stabilization in the Beach-Chair Versus Lateral Decubitus Position: A Systematic Review

Outcomes of Arthroscopic Posterior Shoulder Stabilization in the Beach-Chair Versus Lateral Decubitus Position: A Systematic Review

Outcomes of arthroscopic capsular release for the diabetic frozen shoulder in Asian patients

Return to Sport at 6 Months After Shoulder Surgery

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