Arthroscopic anterior capsular release for idiopathic frozen shoulder

Abstract

IntroductionFrozen shoulder (Adhesive capsulitis) has been defined as a condition characterized by both active and passive loss of motion. Zuckerman et al further classified Frozen shoulder into primary and secondary groups. Primary or idiopathic frozen shoulder has by definition no clear cause. The initial treatment consists of conservative management with NSAID, Physiotherapy, intra-articular steroids or saline and in some instances manipulation under anaesthesia. Once in a while there are cases which are refractory to conservative treatment and manipulation under anaesthesia has its risks like fractures and rotator cuff tears. Arthroscopic capsular release of stiff shoulders has been done providing excellent functional outcome and reproducible results. AimThe purpose of this study was to prospectively evaluate the efficacy of arthroscopic anterior capsular release for patients with refractory idiopathic adhesive capsulitis. Methods26 patients (sixteen males, ten females) with a mean age of 58.4 years (range; 44-72 years) were followed up at our institution. Arthroscopic anterior capsular release was done using two portals. Synovectomy was done using a shaver and capsular release was done using radiofrequency ablator. ResultsThe functional outcome was evaluated using ASES (American Shoulder and Elbow Society) and Constant and Murley scoring system. At 12 months, mean improvement in ASES score was 38 points and Constant and Murley score was 40.5 points. Out of 26 patients 22 said that they would recommend the procedure to someone