Clinical Outcomes of Arthroscopic 360° Capsular Release for Idiopathic Adhesive Capsulitis in the Lateral Decubitus Position

Cvetanovich, Gregory L.; Leroux, Timothy; Bernardoni, Eamon D.; Hamamoto, Jason T.; Saltzman, Bryan M.; Verma, Nikhil N.; Romeo, Anthony A.

doi:10.1016/j.arthro.2017.08.249

Cited by 26 publications

(37 citation statements)

References 30 publications

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“…1,2 In previous studies, rotator interval release or tissue removal operations were performed with an intra-articular view, with the arthroscope placed into the joint through the posterior portal and instruments placed into the rotator interval through the anterior portal. [3][4][5][6] Clinically, we found that the intra-articular approach always resulted in incomplete rotator interval tissue release and removal, and an outside-in release technique has to be performed to complete the procedure. In the case of severe contracture or fibrosis of the shoulder joint, which results in inaccessibility of the glenohumeral joint, an intra-articular rotator interval release cannot be carried out.…”

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confidence: 97%

Arthroscopic Outside-In Rotator Interval Release

Tang

Zhao

2020

Arthroscopy Techniques

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Rotator interval release is an important procedure used in many shoulder operations. It is currently performed through an intra-articular approach, which may result in incomplete release or tissue removal. Here, we introduce an outside-in rotator interval release technique for complete rotator interval tissue removal, which is performed mainly through the lateral portal and a distal anterior portal under the coracoacromial arch. This technique can be used for many shoulder conditions, such as severe joint contracture or fibrosis, fixed shoulder dislocation, or disorders of the long head of the biceps. Our experience indicates that this technique is easy, effective, and capable of addressing even the most difficult shoulder conditions. We believe that adoption of this technique by surgeons can facilitate the success of many shoulder operations.

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confidence: 97%

Arthroscopic Outside-In Rotator Interval Release

Tang

Zhao

2020

Arthroscopy Techniques

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“…There were 2 studies (2 LD position) 3,4 that performed ACR by release of only the rotator cuff interval and the contracted coracohumeral ligament, 1 study (1 BC position) 28 by release of the superior edge of the subscapularis, 12 studies (8 BC position, 8,16,17,33,36,42,43,45 4 LD position 5,22,30,41 ) by release of the anterior capsule, 11 studies (6 BC position, 8,16,17,28,33,40 5 LD position 3–5,22,30 ) by release of the posterior capsule, 1 study (1 LD position 6 ) by 270° capsulectomy, and 12 studies (4 BC position, 2,25,26,35 8 LD position 7,12–14,18,19,32,34 ) by 360° capsulectomy.…”

Section: Resultsmentioning

confidence: 99%

“…This was then followed by gentle manipulation of the shoulder joint in 22 studies (12 BC position, ¶ 10 LD position 3–7,14,22,32,34,41 ). Additionally, 7 studies (2 BC position, 8,25 5 LD position 12,13,19,30,39 ) clearly stated that no concomitant manipulation was performed, while 1 LD study 30 did not clearly state whether concomitant manipulation was performed. In the BC group, no patients underwent an additional surgical intervention to address bone fractures, rotator cuff or biceps tendon tears, loose bodies, subacromial depression, or arthritis.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, 3 studies 18,19,39 reported only individual parameters of the CMS. A BC study 42 reported only mean improvement in CMS values, 1 LD study 5 reported only the normalized CMS percentage, and another LD study 12 reported only postoperative outcome scores; these studies were consequently excluded from the analysis. There were 9 studies (4 BC position, 28,35,43,45 5 LD position 3,7,12,14,41 ) that reported ASES scores.…”

Section: Resultsmentioning

confidence: 99%

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Outcomes of Arthroscopic Capsular Release in the Beach-Chair Versus Lateral Decubitus Position: A Systematic Review

Houck

Belk

Vidal

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background:Arthroscopic capsular release (ACR) for the treatment of adhesive capsulitis of the shoulder can be performed in either the beach-chair (BC) or lateral decubitus (LD) position.Purpose:To determine the clinical outcomes and recurrence rates after ACR in the BC versus LD position.Study Design:Systematic review; Level of evidence, 4.Methods:A systematic review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed by searching PubMed, Embase, and the Cochrane Library databases for studies reporting clinical outcomes of patients undergoing ACR in either the BC or LD position. All English-language literature from 1990 through 2017 reporting on clinical outcomes after ACR with a minimum 3-month follow-up were reviewed by 2 independent reviewers. Recurrence rates, range of motion (ROM) results, and patient-reported outcome (PRO) scores were collected. Study methodological quality was evaluated using the modified Coleman Methodology Score (MCMS).Results:A total of 30 studies (3 level 1 evidence, 2 level 2 evidence, 4 level 3 evidence, 21 level 4 evidence) including 665 shoulders undergoing ACR in the BC position (38.1% male; mean age, 52.0 ± 3.9 years; mean follow-up, 35.4 ± 18.4 months) and 603 shoulders in the LD position (41.8% male; mean age, 53.0 ± 2.3 years; mean follow-up, 37.2 ± 16.8 months) were included. There were no significant differences in overall mean recurrence rates between groups (BC, 2.5%; LD, 2.4%; P = .81) or in any PRO scores between groups (P > .05). There were no significant differences in improvement in ROM between groups, including external rotation at the side (BC, 36.4°; LD, 42.8°; P = .91), forward flexion (BC, 64.4°; LD, 79.3°; P = .73), abduction (BC, 77.8°; LD, 81.5°; P = .82), or internal rotation in 90° of abduction (BC, 40.8°; LD, 45.5°; P = .70). Significantly more patients in the BC group (91.6%) underwent concomitant manipulation than in the LD group (63%) (P < .0001). There were significantly more patients with diabetes in the LD group (22.4%) versus the BC group (9.6%) (P < .0001).Conclusion:Low rates of recurrent shoulder stiffness and excellent improvements in ROM can be achieved after ACR in either the LD or BC position. Concomitant manipulation under anesthesia is performed more frequently in the BC position compared with the LD position.

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“…The effectiveness of shoulder release has been proven in many previous studies [7][8][9] ; however, in most of these studies, shoulder contracture would be classified as slight or moderate according to our clinical classifications. Shoulder release in cases of severe or extremely severe joint contracture is challenging for surgeons because of the difficulty in gaining intraarticular access.…”

Section: Discussionmentioning

confidence: 96%

Arthroscopic Outside-in Shoulder Release for Patients With an Inaccessible Glenohumeral Joint

Tang

Zhao

2020

Arthroscopy Techniques

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Severe shoulder contracture, which usually results from severe frozen shoulder or traumatic arthrofibrosis, is clinically quite common. This condition requires surgical release resulting from severe functional impediment. However, most surgeons are reluctant to operate on such patients because the glenohumeral joint is always inaccessible because of contracture severity. Thus, we introduced an outside-in shoulder release technique starting from the posterior side of the glenohumeral joint. This procedure includes the fabrication of posterior and inferior posterior portals, locating the glenohumeral space out of the capsule, creating working space just posterior to the posterior capsule, releasing the posterior capsule, and thereafter releasing the inferior and superior capsules. Our clinical experience indicates that this procedure can be performed safely and effectively when certain guidelines are followed and can allow for subsequent access to the glenohumeral joint in most cases. We think the introduction of this technique will provide a special surgical option for patients with severe joint contracture.

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Clinical Outcomes of Arthroscopic 360° Capsular Release for Idiopathic Adhesive Capsulitis in the Lateral Decubitus Position

Cited by 26 publications

References 30 publications

Arthroscopic Outside-In Rotator Interval Release

Arthroscopic Outside-In Rotator Interval Release

Outcomes of Arthroscopic Capsular Release in the Beach-Chair Versus Lateral Decubitus Position: A Systematic Review

Arthroscopic Outside-in Shoulder Release for Patients With an Inaccessible Glenohumeral Joint

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