Midterm Outcomes After Arthroscopic Anteroinferior Capsular Release for the Treatment of Idiophatic Adhesive Capsulitis

Arthroscopy. 2017 Mar;33(3):503-508. doi: 10.1016/j.arthro.2016.08.024. Epub 2016 Nov 17.

Abstract

Purpose: The purpose of this study is to report the early and midterm functional outcomes and complications of a consecutive series of patients with primary adhesive capsulitis who were treated with isolated anteroinferior arthroscopic capsular release after they did not respond to conservative treatment.

Methods: Thirty-two consecutive patients with idiopathic adhesive capsulitis who did not respond to conservative physiotherapy were included in the study. Arthroscopic anteroinferior capsular release was performed in all cases. The primary outcome was improvement in range of motion in the short- and midterm follow-up. We also evaluated pain relief with the visual analog scale, functional outcomes with the Constant-Murley score, and we registered postoperative complications.

Results: The mean age was 49.6 years (range, 33-68 years) and the mean follow-up was 63 months (range, 18-84). Overall, there was significant improvement in the Constant-Murley score from 42.4 to 86 points (P < .001). The visual analog scale decreased by approximately 6.3 points compared with the preoperative value (P < .001). All parameters improved significantly the first 6 months and then remained stable until the end of follow-up (P < .001). There was an additional minor improvement in both parameters between the sixth month and the final follow-up; however, this improvement was less than in the first 6 months and it was not statistically significant.

Conclusions: In patients who don't respond to conservative treatment for primary adhesive capsulitis, isolated anteroinferior capsular release provides a reliable improvement in pain and range of motion that is maintained in the mid-term follow-up.

Level of evidence: Level IV, therapeutic, case series study.

MeSH terms

  • Adult
  • Aged
  • Arthroscopy*
  • Bursitis / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Joint Capsule Release*
  • Male
  • Middle Aged
  • Range of Motion, Articular
  • Shoulder Joint / surgery*
  • Visual Analog Scale
  • Young Adult