Arthroscopic 360 degrees capsular release for treatment of adhesive capsulitis– A study of 40 cases
Journal Title: International Journal of Orthopaedics Sciences - Year 2017, Vol 3, Issue 1
Abstract
Introduction: Adhesive capsulitis, better known as frozen shoulder is a common disabling musculoskeletal disease, characterized classically by pain and restriction in range of motion. Management of this condition is controversial, ranging from non-operative to operative interventions, all intending to decrease pain and restore joint function. Arthroscopic capsular release has emerged as an effective surgical procedure for treating adhesive capsulitis. The aim of this study was to evaluate the results of arthroscopic capsular release for adhesive capsulitis Methods: Between February 2013 and May 2015, 40 patients underwent arthroscopic capsular release non responsive to conservative management. Patients having rotator cuff disease, osteoarthritis, history of fracture upper end humerus and bilateral adhesive capsulitis were excluded from the study. Patients were followed up for a minimum period of 11 months. Results were evaluated using Constant score, UCLA (University of California Los Angeles) and VAS (Visual Analog Scale) scoring system. Results: The mean age of the patients was 57.1 years, with 13 male (32.5%) and 27 female (67.5.5%) patients. The right and left shoulder were affected in 31 patients (77.5%) and 9 patients (22.5%) respectively. 21 patients were diabetic (52.5%), 6 patients had a history of trauma (15%) whereas 13 patients had primary idiopathic adhesive capsulitis (42.5%). Post-operatively, the mean time to achieve maximum pain relief was 1.7 months, whereas the mean time to achieve maximum gain in range of motion was 2 months. Mean preoperative range of motion (Anterior Elevation/ Abduction/ External Rotation/ Internal Rotation) was 98.20/36.30/21.10/13.80 whereas post-operatively it increased to 178.50/166.80/55.70/48.10. The average VAS, Constant and UCLA score was 8.7, 27.5 & 12.8, which improved to 2.3, 88.8 & 31.3 respectively. Conclusion: The results of arthroscopic capsular release for adhesive capsulitis are encouraging and provide an effective treatment modality to provide pain relief restore joint function in cases resistant to conservative management
Authors and Affiliations
Dr. Umesh Jadhav, Dr. Dhaval Gotecha
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