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General Orthopaedics

ARTHROSCOPIC CAPSULAR EXCISION IN THE TREATMENT OF ADHESIVE CAPSULITIS OF THE SHOULDER

Combined Services Orthopaedic Society (CSOS) - 32nd Meeting



Abstract

Adhesive capsulitis of the shoulder is a common debilitating condition with prevalence in the order of 2 to 5%. Whilst it is usually a self-limiting condition, patients are typically not willing, nor are they able, to wait to the end of the recovery phase. A number of treatment strategies have been described. Manipulation under anaesthesia can significantly increase motion in all planes, but carries a significant risk of fracture. Capsular release also significantly improves motion with fewer potential side effects.

We hypothesise that performing an arthroscopic excision of the abnormal capsulitis tissue will give better results with least risk of recurrence. Data was collected both retrospectively and prospectively for patients undergoing this procedure. Range of motion and Oxford shoulder scores was documented pre-operatively and post-operatively, at 6 weeks, 3 months and 6 months. 41 patients were included. At 3 months mean flexion had increased from 101 to 152 degrees, abduction from 91 to 151 degrees, and external rotation from 18 to 44 degrees. Mean Oxford shoulder score had increased from 20.6 to 35.8 at 3 months.

The results support the use of this technique for treating adhesive capsulitis. Larger patient numbers and longer term follow up will help compare it against the other well established techniques.