Abstract
Purpose
The purpose of this prospective study was to compare the functional results and patient satisfaction after arthroscopic shoulder capsular release in patients with idiopathic and posttraumatic stiff shoulder.
Methods
The study included 50 patients who underwent arthroscopic capsular release after failure of conservative treatment. The etiology of stiffness was either idiopathic (25 patients) or post-traumatic (25 patients). There were 28 women and 22 men with an average age of 49 years (range, 32–70 years). All patients were treated with physical therapy for a mean of six months (range, 3–12 months) before surgery. Range of motion was measured three times: 48 hours after surgery, then one month and six months after surgery.
Results
Constant score showed improvement for both groups of patients in the period of six months after surgery. In the group with idiopathic stiffness the score increased from 36 to 86, while in the group with post-traumatic stiff shoulder the score advanced from 32 to 91. The idiopathic stiff shoulder group had an improved active forward flexion from 90 to 161°, external rotation from 10 to 40°, and internal rotation from L5 to L1. In the post-traumatic stiff shoulder groupthe forward flexion was improved from 95 to 170°, external rotation from 13 to 40° and internal rotation from L4 to L1.
Conclusion
There was an improvement of range of motions and patients' satisfaction after arthroscopic shoulder capsular release and manipulation under anesthesia, equally in idiopathic and post-traumatic stiff shoulder, compared to the situation before surgery. Post-traumatic contracture patients expressed higher level of satisfaction with their shoulder function than the idiopathic stiff shoulder patients.
Similar content being viewed by others
References
Warner JJ (1997) Frozen shoulder: diagnosis and management. J Am Acad Orthop Surg 5(3):130–140
Jenkins EF, Thomas WJ, Corcoran JP, Kirubanandan R, Beynon CR, Sayers AE, Woods DA (2012) The outcome of manipulation under general anesthesia for the management of frozen shoulder in patients with diabetes mellitus. J Should Elb Surg 21(11):1492–1498. doi:10.1016/j.jse.2011.11.006
Hand GC, Athanasou NA, Matthews T, Carr AJ (2007) The pathology of frozen shoulder. J Bone Joint Surg 89(7):928–932
Levy O, Webb M, Even T, Venkateswaran B, Funk L, Copeland SA (2008) Arthroscopic capsular release for posttraumatic shoulder stiffness. J Should Elb Surg 17(3):410–414. doi:10.1016/j.jse.2007.11.014
Warner JJ, Allen A, Marks PH, Wong P (1996) Arthroscopic release for chronic, refractory adhesive capsulitis of the shoulder. J Bone Joint Surg Am 78(12):1808–1816
Elhassan B, Ozbaydar M, Massimini D, Higgins L, Warner JJ (2010) Arthroscopic capsular release for refractory shoulder stiffness: a critical analysis of effectiveness in specific etiologies. J Should Elb Surg 19(4):580–587. doi:10.1016/j.jse.2009.08.004
Ando A, Sugaya H, Hagiwara Y, Takahashi N, Watanabe T, Kanazawa K, Itoi E (2013) Identification of prognostic factors for the nonoperative treatment of stiff shoulder. Int Orthop 37(5):859–864. doi:10.1007/s00264-013-1859-8
Clipsham K, Rees JL, Carr JA (2008) Long-term outcome of frozen shoulder. J Should Elb Surg 17(2):231–236
Scarlat MM, Harryman DT (2000) Management of the diabetic stiff shoulder. Instr Course Lect 49:283–294
Griggs SM, Ahn A, Green A (2000) Idiopathic adhesive capsulitis. A prospective functional outcome study of nonoperative treatment. J Bone Joint Surg Am 82-A(10):1398–1407
Tauro CJ, Paulson M (2008) Shoulder stiffness. Arthroscopy. J Arthrosc Relat Surg 24(8):949–955
De Carli A, Vadalà A, Perugia D, Frate L, Iorio C, Fabbri M, Ferretti A (2012) Shoulder adhesive capsulitis: manipulation and arthroscopic arthrolysis or intra-articular steroid injections? Int Orthop 36(1):101–106. doi:10.1007/s00264-011-1330-7
Dattani R, Ramasamy V, Parker R, Patel VR (2013) Improvement in quality of life after arthroscopic capsular release for contracture of the shoulder. Bone Joint J 95-B(7):942–946. doi:10.1302/0301-620X.95B7.31197
Nicholson GP (2003) Arthroscopic capsular release for stiff shoulders: effect of etiology on outcomes. Arthroscopy 19(1):40–49
Beaufils P, Prévot N, Boyer T, Allard M, Dorfmann H, Frank A, Kelbérine F, Kempf JF, Molé D, Walch G (1999) Arthroscopic release of the glenohumeral joint in shoulder stiffness: a review of 26 cases. Arthroscopy 15(1):49–55
Harryman DT, Matsen FA, Sidles JA (1997) Arthroscopic management of refractory shoulder stiffness. Arthroscopy 13(2):133–147
Gerber C, Espinosa N, Perren TG (2001) Arthroscopic treatment of shoulder stiffness. Clin Orthop Relat Res Sep 390:119–128
Watson L, Dalziel R, Story I (2000) Frozen shoulder: a 12-month clinical outcome trial. J Should Elb Surg 9(1):16–22
Harryman DT 2nd (1993) Shoulders: frozen and stiff. Instr Course Lect 42:247–257
Le Lievre HMJ, Murrell GAC (2012) Long-term outcomes after arthroscopic capsular release for idiopathic adhesive capsulitis. J Bone Joint Surg Am 94(13):1208–1216. doi:10.2106/JBJS.J.00952
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Trsek, D., Cicak, N., Zunac, M. et al. Functional results and patient satisfaction after arthroscopic capsular release of idiopathic and post-traumatic stiff shoulder. International Orthopaedics (SICOT) 38, 1205–1211 (2014). https://doi.org/10.1007/s00264-014-2283-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-014-2283-4