ARTHROSCOPIC SHOULDER CAPSULAR RELEASE FOR FROZEN SHOULDER. IS IT EFFECTIVE?

Abstract

Introduction: Idiopathic Adhesive capsulitis [IAC] of the shoulder is a self limited condition that can cause significant morbidity. Most patients (90%) respond to conservative management and those who fails (10%) undergo manipulation under anaesthesia (MUA) Patients who are refractory to both treatments, benefits from arthroscopic capsular release.

Aim: To assess the efficacy of arthroscopic capsular release in patients with IAC refractory to physiotherapy and MUA. Also to compare the clinical outcome between arthroscopic capsular release and MUA.

Materials and methods: We studied 59 patients with IAC, divided into 2 groups. Group A [36patients] had MUA and Group B [23 patients] underwent arthroscopic capsular release. The mean age was (54years).

The mean follow up was 21 and 9 months for group A and B respectively.

Results: We assessed our results according to three parameters:

1. Final outcome using the Constant and Murley score. The improvement in the score averaged 42 and 47 points in group A and B respectively

2. Early Post operative pain using visual analogue score (VAS) average of 6 and 3 in group A and B respectively

3. Overall patient satisfaction: 81% in group A and 89% in group B.

Conclusion:

• Patients with IAC who fails to respond physiotherapy and MUA do well after arthroscopic capsular release with little operative morbidity.

• Complete normal functional outcome of shoulder is not a prerequisite for patient satisfaction.