[Arthroscopic selective capsular release in the treatment of frozen shoulder]

Abstract

Objectives: We evaluated the results of arthroscopic selective capsular release in patients with frozen shoulder.

Methods: Sixteen patients (5 males, 11 females; mean age 51 years; range 25 to 73 years) underwent arthroscopic capsular release for frozen shoulder. The syndrome was due to trauma in two patients; nine patients had diabetes mellitus; no etiologic cause was found in three patients. Two patients had rotator cuff tendinitis. The mean duration of complaints was 14 months (range 3 to 36 months). The patients were treated conservatively for a mean of 9.5 months (range 3 to 12 months). The range of motion of the shoulder was measured with a goniometer. Functional evaluations were made according to the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES). Under general anesthesia, all the patients underwent arthroscopic capsular release, subacromial bursoscopy, and manipulation. Acromioplasty was performed in two patients with subacromial impingement. The mean follow-up was 14 months (range 4 to 25 months).

Results: Compared to the healthy side, postoperative increments in flexion, adduction-external rotation, abduction-internal and external rotations were 38%, 47%, 43%, and 30%, respectively. The strength of the infraspinatus, supraspinatus, and subscapularis muscles significantly increased (p<0.05). The mean postoperative ASES score improved by 50 (p<0.05). The mean visual analog scale score decreased significantly with significant improvements in daily activities (p<0.05). Complaints of pain and limitation disappeared in a mean of 3.5 months (range 15 days-12 months) in 14 patients (87.5%) who were fully satisfied with the operation.

Conclusion: Patients with frozen shoulder unresponsive to conservative treatment can be effectively treated with arthroscopic selective capsular release and manipulation.