L-shaped arthroscopic posterior capsular release in frozen shoulder

Abstract

Background Arthroscopic capsular release in refractory cases of primary frozen shoulder is a well-established and acknowledged procedure with successful outcome. Nonetheless, postoperative limitation of internal rotation is a common complaint that diminishes the postoperative success.Purpose The purpose of this prospective study was to assess the results of a new L-shaped arthroscopic posterior capsular release and compare it with the standard longitudinal technique.Patients and methods Forty-three consecutive patients with primary frozen shoulder in whom conservative medical, physiotherapy, and/or local steroid injection failed to relieve the symptoms were included in the study. Arthroscopic capsular release was performed in all cases. Group 1 underwent the standard longitudinal anterior and posterior release only; group 2 underwent an additional L-shaped posterior capsular release. Constant–Murley functional score was used to assess the overall outcome and patient satisfaction.Results The mean age of the patients was 49 years (range: 27–67 years), with no statistical difference between the two groups. There were 22 patients in group 1 and 21 patients in group 2. The mean follow-up period was 34 months (range: 24–42 months). At the final follow-up, there was a highly significant improvement in Constant score (P<0.001) postoperatively in both groups. A similar finding was noted in the overall range of motions (P<0.001). However, group 2 showed a significant difference in the improvement of the internal rotation range of motion postoperatively.Conclusion The L-shaped arthroscopic posterior capsular release in patients with primary frozen shoulder is a new technique that significantly improves the postoperative internal rotation range of motion.