Ultrasound-Guided Interventional Release of Rotator Interval and Posteroinferior Capsule for Adhesive Capsulitis of the Shoulder Using a Specially Designed Needle

Abstract

Background: Adhesive capsulitis is a common but poorly understood disorder of the shoulder. Various treatments have been developed to manage this condition, but the efficacy of these treatments is controversial. We developed an ultrasound-guided, minimally invasive interventional technique to manage adhesive capsulitis of the shoulder using a specially designed needle. Objective: To describe the methodological approach of our intervention. Study Design: Technical report. Setting: Pain management clinic. Methods: Thirteen participants with adhesive capsulitis of the shoulder underwent ultrasound-guided interventional release of the rotator interval and posteroinferior capsule using a specially designed curved Round Needle. A convex ultrasound probe was placed along the oblique coronal plane over the supraspinatus muscle and acromion. Under ultrasonographic guidance, the needle was passed through the supraspinatus muscle and superior labrum and reached the rotator interval. It was moved forward and backward until no resistance was felt. After finishing the rotator interval release, the needle was inserted toward the posteroinferior capsule. While the operator released the adhesion in the posteroinferior capsule by moving the needle forward and backward, an assistant gradually abducted the shoulder. When full abduction of the affected shoulder was achieved, the intervention was completed. Results: Following our intervention, significant improvements in pain levels, glenohumeral range of motion, and Quick Disability of the Arm, Shoulder, and Hand scores were attained at follow-up. Limitations: Technical report only. Efficacy of this technique is beyond the scope of the article. Conclusion: Ultrasound-guided interventional release of the rotator interval and posteroinferior capsule appears to have clinical significance in the management of adhesive capsulitis of the shoulder. Key words: adhesive capsulitis, shoulder, ultrasound, intervention, dry needling, technique