Functional results and patient satisfaction after arthroscopic capsular release of idiopathic and post-traumatic stiff shoulder

Abstract

Purpose The purpose of this prospective study was to compare the functional results and patient satisfaction after arthroscopic shoulder capsular release in patients with idiopathic and posttraumatic stiff shoulder. Methods The study included 50 patients who underwent arthroscopic capsular release after failure of conservative treatment. The etiology of stiffness was either idiopathic (25 patients) or post-traumatic (25 patients). There were 28 women and 22 men with an average age of 49 years (range, 32-70 years). All patients were treated with physical therapy for a mean of six months (range, 3-12 months) before surgery. Range of motion was measured three times: 48 hours after surgery, then one month and six months after surgery. Results Constant score showed improvement for both groups of patients in the period of six months after surgery. In the group with idiopathic stiffness the score increased from 36 to 86, while in the group with post-traumatic stiff shoulder the score advanced from 32 to 91. The idiopathic stiff shoulder group had an improved active forward flexion from 90 to 161°, external rotation from 10 to 40°, and internal rotation from L5 to L1. In the post-traumatic stiff shoulder groupthe forward flexion was improved from 95 to 170°, external rotation from 13 to 40°and internal rotation from L4 to L1. Conclusion There was an improvement of range of motions and patients' satisfaction after arthroscopic shoulder capsular release and manipulation under anesthesia, equally in idiopathic and post-traumatic stiff shoulder, compared to the situation before surgery. Post-traumatic contracture patients expressed higher level of satisfaction with their shoulder function than the idiopathic stiff shoulder patients.

Effect of nonoperative concomitant intraarticular pathologies on the outcome of arthroscopic capsular release for adhesive capsulitis of the shoulder

“…In the literature, prognostic factors for the operative and nonoperative treatment of stiff shoulder have been identified as etiology of stiffness, age of 60 years or over and external rotation under 0° on the first visit. 15 , 19 However, effect of concomitant intraarticular lesions on the results of arthroscopic release of the frozen shoulder remains unclear. This study was performed to investigate whether the concomitant intraarticular shoulder pathologies are predictors of unfavorable outcomes of the arthroscopic capsular release.…”

“…In the treatment of frozen shoulder, arthroscopic capsular release has been reported as a successful method. 13 , 14 , 15 One of the advantages of the arthroscopic capsular release is detection and simultaneous treatment of coexistent intraarticular pathologies such as superior labrum anterior to posterior lesion (SLAP), partial or total tear of the rotatory cuff (RC) and cartilage lesions. In the literature, it is not clear whether additional intraarticular shoulder pathologies are predictors of fair results of the arthroscopic capsular release.…”

CORR Insights®: Stretching After Heat But Not After Cold Decreases Contractures After Spinal Cord Injury in Rats

“…Connective tissue around synovial joints, known as the joint capsule, responds to extended periods of immobility and limits ROM [10,11]. The application of cutting-edge methods to measure genome-wide expression in the capsule led to the identification of biochemical pathways altered during the progression of a flexion contracture [13].…”

Arthroskopische Arthrolyse bei Schultersteife

“…Hierfür hat sich als operative Maßnahme die arthroskopische Arthrolyse mit einer hohen Erfolgsrate und geringen Risiken gegenüber offenen Verfahren und der alleinigen Narkosemobilisation durchgesetzt [1,5,11,15]. Das Prinzip einer arthroskopisch geschlossenen Eröffnung der gesamten Gelenkkapsel ist mit verschiedenen Techniken zu erreichen [2,4,5,8,10,17]. Mehrere Autoren nutzen eine Narkosemobilisation nach der arthroskopischen Operation zur Vervollständigung des Release [2,4,17].…”

“…Das Prinzip einer arthroskopisch geschlossenen Eröffnung der gesamten Gelenkkapsel ist mit verschiedenen Techniken zu erreichen [2,4,5,8,10,17]. Mehrere Autoren nutzen eine Narkosemobilisation nach der arthroskopischen Operation zur Vervollständigung des Release [2,4,17]. Die Anwendung bipolarer Elektroden wird empfohlen, um den Nervus axillaris bei der Durchtrennung des kaudalen Kapselgewebes nicht zu schädigen [8,9,11,18].…”