Mid term effects of 360 degrees arthroscopic capsular release for primary frozen shoulder

doi:10.3877/cma.j.issn.1674-134X.2019.01.002

Abstract

Abstract:

Objective

To investigate the feasibility and effectiveness of 360 degrees arthroscopic capsular release for the treatment of primary frozen shoulder.

Methods

Twenty three patients with primary frozen shoulder from January 2010 to September 2014, including eight males and 15 females with an average age of (58±10) years were enrolled in this study. Cases with cervical spondylopathy, tumor, thoracic outlet syndrome as well as the secondary shoulder stiffness following shoulder injury, surgery or external fixation of shoulder were excluded. Arthroscopic capsular release was performed under general anesthesia in all patients. VAS pain score and Constant score of patients were assessed and compared before and after surgery by paired t test. The joint activity of the affected side was also analyzed.

Results

All the operations were successfully completed, the incisions healed well and no complications were observed. Twenty of 23 cases were followed up, accounting for a follow-up rate of 86.7%, with an average follow-up time of (46±18) months. The Constant score of shoulder three months after operation was (90.2±1.3) and the the VAS score was 1(1, 2); both were statistically significant compared with the preoperation data(t=38, P<0.05; Z=-4.0, P<0.01). The Constant score of shoulder 12 months after operation was (92.2±1.1) and the VAS score was 0(0, 1); both were statistically significant compared with preoperation state(t=5.2, P<0.05)(t=-3.7, P <0.01). The Constant score of shoulder 24 months after operation was (92.4±0.9) and the media of the VAS score was 0(0, 1); both were not statistically significant compared with preoperation data(t=0.8, t=-1.4, both P>0.05). The mean range of motion of forward flexion, abduction, external rotation and interal rotation also improved significantly postoperatively compared with preoperative ones.

Conclusion

Three hundred and sixty degrees arthroscopic capsule release is an effective method for the treatment of primary frozen shoulder of which the mid-term clinical effect is satisfied.

Key words: Arthroscopy, Shoulder joint

Kejie Wang, Peng Xu, Wenge Ding, Weihong Yan, Huan Li. Mid term effects of 360 degrees arthroscopic capsular release for primary frozen shoulder[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2019, 13(01): 6-10.

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Figures/Tables 2

References 29

[1]	Binder AI, Bulgen DY, Hazleman BL, et al. Frozen shoulder: a long-term prospective study[J]. Ann Rheum Dis, 1984, 43(3): 361-364.
[2]	Shaffer B, Tibone JE, Kerlan RK. Frozen shoulder. A long-term follow-up[J]. J Bone Joint Surg Am, 1992, 74(5): 738-746.
[3]	Constant CR, Murley AH. A clinical method of functional assessment of the shoulder[J]. Clin Orthop Relat Res, 1987, 214: 160-164.
[4]	Maund E, Craig D, Suekarran S, et al. Management of frozen shoulder: a systematic review and cost-effectiveness analysis[J]. Health Technol Assess, 2012, 16(11): 261-264.
[5]	Prodromidis AD, Charalambous CP. Is there a genetic predisposition to frozen shoulder? A systematic review and meta-analysis[J]. JBJS Rev, 2016, 4(2):1-9.
[6]	Zreik NH, Malik RA, Charalambous CP. Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence[J]. Muscles Ligaments Tendons J, 2016, 6(1): 26-34.
[7]	Itoi E, Arce G, Bain GI, et al. Shoulder stiffness: current concepts and concerns[J]. Arthroscopy, 2016, 32(7):1402-1414.
[8]	Arce G. Primary frozen shoulder syndrome: arthroscopic capsular release [J]. Arthrosc Tech, 2015, 4(6): e717-e720.
[9]	Rizk TE, Pinals RS. Frozen shoulder[J]. Semin Arthritis Rheum, 1982, 11(4): 440-452.
[10]	Mcgahan PJ, Patel H, Dickinson E, et al. The effect of biceps adhesions on glenohumeral range of motion: a cadaveric study[J]. J Shoulder Elbow Surg, 2013, 22(5): 658-665.
[11]	Izumi T, Aoki M, Tanaka Y, et al. Stretching positions for the coracohumeral ligament: strain measurement during passive motion using fresh/frozen cadaver shoulders[J]. Sports Med Arthrosc Rehabil Ther Technol, 2011, 3(1): 1-11.
[12]	Ozaki J, Nakagawa Y, Sakurai G, et al. Recalcitrant chronic adhesive capsulitis of the shoulder. Role of contracture of the coracohumeral ligament and rotator interval in pathogenesis and treatment[J]. J Bone Joint Surg Am, 1989, 71(10): 1511-1515.
[13]	Mengiardi B, Pfirrmann CW, Gerber C, et al. Frozen shoulder: Mr arthrographic findings[J]. Radiology, 2004, 233(2): 486-492.
[14]	Park C, Lee S, Yi CW, et al. The effects of extracorporeal shock wave therapy on frozen shoulder patients＇ pain and functions[J]. J Phys Ther Sci, 2015, 27(12): 3659-3661.
[15]	Favejee MM, Huisstede BM, Koes BW. Frozen shoulder: the effectiveness of conservative and surgical interventions-systematic review[J]. Br J Sports Med, 2011, 45(1): 49-56.
[16]	Saeidian SR, Hemmati AA, Haghighi MH. Pain relieving effect of short-course, pulse prednisolone in managing frozen shoulder[J]. J Pain Palliat Care Pharmacother, 2007, 21(1): 27-30.
[17]	Lorbach O, Anagnostakos K, Scherf C, et al. Nonoperative management of adhesive capsulitis of the shoulder: oral cortisone application versus intra-articular cortisone injections[J]. J Shoulder Elbow Surg, 2010, 19(2): 172-179.
[18]	Loew M, Heichel TO, Lehner B. Intraarticular lesions in primary frozen shoulder after manipulation under general anesthesia[J]. J Shoulder Elbow Surg, 2005, 14(1): 16-21.
[19]	Kivimäki J, Pohjolainen T, Malmivaara A, et al. Manipulation under anesthesia with home exercises versus home exercises alone in the treatment of frozen shoulder: a randomized, controlled trial with 125 patients[J]. J Shoulder Elbow Surg, 2007, 16(6): 722-726.
[20]	Snow M, Boutros I, Funk L. Posterior arthroscopic capsular release in frozen shoulder[J]. Arthroscopy, 2009, 25(1): 19-23.
[21]	Pollock RG, Duralde XA, Flatow EL, et al. The use of arthroscopy in the treatment of resistant frozen shoulder[J]. Clin Orthop Relat Res, 1994, 304: 30-36.
[22]	Fernandes MR. Arthroscopic treatment of refractory adhesive capsulitis of the shoulder[J]. Rev Col Bras Cir, 2014, 41(1): 30-35.
[23]	Smith CD, Hamer P, Bunker TD. Arthroscopic capsular release for idiopathic frozen shoulder with intra-articular injection and a controlled manipulation[J]. Ann R Coll Surg Engl, 2014, 96(1): 55-60.
[24]	Evans JP, Guyver PM, Smith CD. Frozen shoulder after simple arthroscopic shoulder procedures: what is the risk？[J]. Bone Joint J, 2015, 97-B(7): 963-966.
[25]	Segmüller HE, Taylor DE, Hogan CS, et al. Arthroscopic treatment of adhesive capsulitis[J]. J Shoulder Elbow Surg, 1995, 4(6): 403-408.
[26]	Bennett WF. Addressing glenohumeral stiffness while treating the painful and stiff shoulder arthroscopically[J]. Arthroscopy, 2000, 16(2): 142-150.
[27]	Chen J, Chen S, Li Y, et al. Is the extended release of the inferior glenohumeral ligament necessary for frozen shoulder？[J]. Arthroscopy, 2010, 26(4): 529-535.
[28]	Jerosch J. 360 degrees arthroscopic capsular release in patients with adhesive capsulitis of the glenohumeral joint-indication, surgical technique, results[J]. Knee Surg Sports Traumatol Arthrosc, 2001, 9(3): 178-186.
[29]	陆军，王宸．冻结肩的诊疗进展[J/CD]．中华关节外科杂志(电子版)，2015，9(4):527-531.

?	前驱	外展	内旋	外旋
术前	71.5±3.2	71.6±3.0	49.8±2.4	38.7±2.7
术后3个月	148.1±5.4	133.3±2.6	65.3±2.2	48.1±2.2
术后12个月	168.8±3.9	147.9±3.9	79.7±3.1	77.1±1.5
术后24个月	170.5±4.9	148.4±4.3	80.7±2.9	80.0±1.7
t值	55.9^a，14.2^b，1.3^c	71.5^a，14.4^b，0.4^c	21.9^a，17.2^b，1.1^c	12.5^a，50.5^b，1.8^c
P值	<0.05^ab	<0.05^ab	<0.05^ab	<0.05^ab

?	前驱	外展	内旋	外旋
术前	71.5±3.2	71.6±3.0	49.8±2.4	38.7±2.7
术后3个月	148.1±5.4	133.3±2.6	65.3±2.2	48.1±2.2
术后12个月	168.8±3.9	147.9±3.9	79.7±3.1	77.1±1.5
术后24个月	170.5±4.9	148.4±4.3	80.7±2.9	80.0±1.7
t值	55.9^a，14.2^b，1.3^c	71.5^a，14.4^b，0.4^c	21.9^a，17.2^b，1.1^c	12.5^a，50.5^b，1.8^c
P值	<0.05^ab	<0.05^ab	<0.05^ab	<0.05^ab

?	Constant评分(±s)	VAS评分M(P₂₅，P₇₅)
术前	52.1±5.5	9(8，9)
术后3个月	90.2±1.3	1(1，2)
术后12个月	92.2±1.1	0(0，1)
术后24个月	92.4±0.9	0(0，1)
统计值	t ＝38^a，5.2^b，0.8^c	Z＝－4.0^a，－3.7^b，－1.4^c
P值	< 0.05^{a b}	< 0.01^{a b}

?	Constant评分(±s)	VAS评分M(P₂₅，P₇₅)
术前	52.1±5.5	9(8，9)
术后3个月	90.2±1.3	1(1，2)
术后12个月	92.2±1.1	0(0，1)
术后24个月	92.4±0.9	0(0，1)
统计值	t ＝38^a，5.2^b，0.8^c	Z＝－4.0^a，－3.7^b，－1.4^c
P值	< 0.05^{a b}	< 0.01^{a b}

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