Improvement in quality of life after arthroscopic capsular release for contracture of the shoulder

Abstract

There is little published information on the health impact of frozen shoulder. The purpose of this study was to assess the functional and health-related quality of life outcomes following arthroscopic capsular release (ACR) for contracture of the shoulder. Between January 2010 and January 2012 all patients who had failed non-operative treatment including anti-inflammatory medication, physiotherapy and glenohumeral joint injections for contracture of the shoulder and who subsequently underwent an ACR were enrolled in the study. A total of 100 patients were eligible; 68 underwent ACR alone and 32 had ACR with a subacromial decompression (ASD). ACR resulted in a highly significant improvement in the range of movement and functional outcome, as measured by the Oxford shoulder score and EuroQol EQ-5D index. The mean cost of a quality-adjusted life year (QALY) for an ACR and ACR with an ASD was £2563 and £3189, respectively. ACR is thus a cost-effective procedure that can restore relatively normal function and health-related quality of life in most patients with a contracture of the shoulder within six months after surgery; and the beneficial effects are not related to the duration of the presenting symptoms.

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

“…The most common cause of post-traumatic contracture is shortening of soft tissue, primarily inflammations, and later capsular thickening. Recently, the most dominant method used is arthroscopic capsular release, which improves shoulder mobility to a great extent and reduces pain [12,13]. Our results show it clearly.…”

Does arthroscopic subacromial decompression improve quality of life

“…Dattani et al worked out the cost per QALY of arthroscopic capsular release to be £2,563 and the cost of arthroscopic capsular release plus subacromial decompression to be £3,189. 7 These figures are notably lower than those we present as a result of a difference in methodology. Dattani et al used the baseline assessment of the EQ-5D™ and made the assumption this would remain so for 2.5 years.…”

“…Dattani et al used the baseline assessment of the EQ-5D™ and made the assumption this would remain so for 2.5 years. 7 The QALY improvements they found based on their 6-month followup period were then multiplied over the arbitrary 2.5-year Figure 1 The mean preoperative (n=71) and postoperative (n=79) Oxford shoulder scores (with 95% confidence intervals) at mean follow-up for the pooled dataset. The mean improvement was 14 points (p<0.00001).…”

What's changed in the management of the frozen shoulder?

“…It affects people aged 40–60 years (more commonly women), and may affect both shoulders; it does not usually recur in the same shoulder 7,10. It is more prevalent and usually more long lasting and difficult to treat in people with diabetes with a reported incidence of 10–36% 2,7,10,11…”