Effects of Arthroscopic Coracohumeral Ligament Release on Range of Motion for Patients with Frozen Shoulder

Yoshihiro Hagiwara, Takuya Sekiguchi, Akira Ando, Kenji Kanazawa, Masashi Koide, Junichiro Hamada, Yutaka Yabe, Shinichiro Yoshida, Eiji Itoi, Yoshihiro Hagiwara, Takuya Sekiguchi, Akira Ando, Kenji Kanazawa, Masashi Koide, Junichiro Hamada, Yutaka Yabe, Shinichiro Yoshida, Eiji Itoi

Abstract

Background: A thickened coracohumeral ligament is a highly specific manifestation of, and primary restraint against external rotation in frozen shoulders.

Objective: The purpose of this study was to evaluate the effects of complete arthroscopic coracohumeral ligament release on range of motion in frozen shoulder.

Methods: Fifty-two consecutive shoulders in 52 patients were treated between April 2015 and June 2016. To evaluate solely glenohumeral range of motion, the scapula was fixed by an examiner with one hand (without palpating scapular motion), and range of motion was measured using a goniometer. For the first step, arthroscopic pancapsular release was performed in a beach-chair position with (Group 1) or without (Group 2) complete coracohumeral ligament release. For the final step, the remaining coracohumeral ligaments in Group 2 were released and the ranges of motion were compared to those in Group 1.

Results: The average age of the patients was significantly higher in Group 1, but there were no significant differences between the two groups with respect to sex, affected side, preoperative range of motion, or American Shoulder and Elbow Society Score. Abduction, external rotation at adduction, and external and internal rotations at 90° of flexion in Group 1 were significantly greater than those in Group 2. After the additional release of the remaining coracohumeral ligaments in Group 2, all ranges of motion were significantly recovered and there was no significant difference between the groups.

Conclusion: Complete coracohumeral ligament release is a recommended intraoperative procedure for regaining full range of motion in frozen shoulders.

Keywords: Adhesive capsulitis; Arthroscopic capsular release; Beach chair position; Coracohumeral ligament; Frozen shoulder; Goniometer; Joint capsule; Range of motion.

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