Abstract
Purpose of the study: Therapeutic options for retractile capsulitis ranges from therapeutic abstention to arthroscopic arthrolysis. The purpose of this work was to examine the efficacy of a simple therapeutic option (arthrodistention + self-mobilisation).
Material and methods: This was a prospective study of a consecutive series of 41 patients (28 female, 13 male), dominant shoulder 57%. Inclusion criteria were deficient in passive range of motion ≥ 50% compared with the other side in at least two planes, without notion of trauma or surgery. Diagnosis and inclusion: one surgeon. Arthrodistension with corticosteroid injection: one radiologist. Recommendations for self-rehabilitation, the day of the arthrodistension: one physical therapist. Patients were reviewed at 30, 90 and 180 days to analyse pain (visual analogue scale, VAS), daily life activities (Constant score), range of motion.
Results: From day 1 to 6 months –VAS regressed from 5.8 (2 – 9) to 0.8 (0/2). Constant daily activity score improved from 1/4 to 3.6/4; FA from 82 (60/115) to 170; (150/180); Re1 from 5 (−10/30) to 50 (20/70); RI from 12 (0 – 30) to 30 (10/60). Recovery was correlated with deficit in RI (p< 0.005). The greater the RI deficit the less rapid the recovery.
Discussion: We did not use the overall Constant score because of the difficulty in evaluating force. An analysis of the literature shows that therapeutic abstention can provide recovery, but with a delay of about two years. Arthroscopic arthrolysis, interscalenic blocks provide a much quicker recovery (6 months). The results obtained here are comparable with those obtained with these more complex methods./
Conclusion: This study shows that a simple management strategy enables the same results as with more invasive and more costly techniques. The patient should be warned that an important deficit in RI will undoubtedly lead to a slower recovery.
Correspondence should be addressed to Ghislaine Patte at sofcot@sofcot.fr
