Effectiveness of arthroscopic capsular release to treat primary severe frozen shoulder through trans cuff portal_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LU Zhenfei ¹ , WANG Jianhua ² , XU Bing ¹ , YOU Weijia ¹ ,  WANG Jianwei ¹

1. Department of Orthopedics, Wuxi Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Wuxi Jiangsu, 214000, P.R.China;
2. Department of Orthopedics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, 200092, P.R.China;

Corresponding?author：

WANG Jianwei, Email: osteowjw@163.com

Keywords：

Primary severe frozen shoulder; arthroscopy; release; trans cuff portal approach

DOI：

10.7507/1002-1892.201702012

Video：

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Objective To assess the effectiveness of arthroscopic capsular release to treat primary severe frozen shoulder through trans cuff portal. Methods Between June 2012 and January 2015, 28 patients with primary severe frozen shoulder were enrolled in the study. There were 8 males and 20 females with an average age of 57 years (range, 42-81 years). The left shoulder was involved in 16 cases and the right one in 12 cases. The mean disease duration was 11 months (range, 7-21 months). Six patients had diabetes. All patients underwent arthroscopic capsular release by trans cuff portal. The range of motion (ROM) of the shoulder were measured at preoperation and at 6 weeks and 24 months after operation; the scores of American Shoulder and Elbow Surgeons (ASES) and visual analogue scale (VAS) were used to evaluate the shoulder function and pain. Results Primary healing of incision was obtained, and no complications of infection, shoulder instability, and nerve injury were found. All patients were followed up 24 months. Pain of the shoulder was obviously relieved; VAS score was significantly lower at 6 weeks and 24 months after operation than preoperation (P<0.05), and at 24 months than 6 weeks (P<0.05). ROM of the shoulder and ASES score at 6 weeks and 24 months after operation were significantly increased when compared with preoperative ones (P<0.05); significant difference was found in ROM of forward flexion and external rotation and the ASES score between at 6 weeks and 24 months (P<0.05). And internal rotation in-creased from trochanter (9 cases), hip (6 cases), sacrum (7 cases), and L₄ vertebral level (6 cases) before operation to the T₁₂-T₆ vertebral level at 6 weeks and 24 months after operation, which were close to normal side. Conclusion Arthroscopic capsular release through trans cuff portal is an effective and safe management for primary severe frozen shoulder.

Citation： LU Zhenfei, WANG Jianhua, XU Bing, YOU Weijia, WANG Jianwei. Effectiveness of arthroscopic capsular release to treat primary severe frozen shoulder through trans cuff portal. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(7): 773-777. doi: 10.7507/1002-1892.201702012 Copy

1.	Itoi E, Arce G, Bain GI, et al. Shoulder Stiffness: Current Concepts and Concerns. Arthroscopy, 2016, 32(7): 1402-1414.
2.	Garsman GM. 肩關節鏡手術學. 徐衛東, 陳世益, 陳百成, 主譯. 上海: 第二軍醫大學出版社, 2008: 139.
3.	王海明, 趙金忠, 皇甫小橋, 等. 原發性凍結肩關節鏡手術干預時機選擇對療效的影響. 中華老年醫學雜志, 2016, 35(7): 743-748.
4.	Jerosch J, Nasef NM, Peters O, et al. Mid-term results following arthroscopic capsular release in patients with primary and secondary adhesive shoulder capsulitis. Knee Surg Sports Trauma, 2013, 21(5): 1195-1202.
5.	Grant JA, Schroeder N, Miller BS, et al. Comparison of manipulation and arthroscopic capsular release for adhesive capsulitis: a systematic review. J Shoulder Elbow Surg, 2013, 22(8): 1135-1145.
6.	Thompson SR, Lebel ME. Use of a hip arthroscopy flexible radiofrequency device for capsular release in frozen shoulder. ArthroscTech, 2012, 1(1): e75-78.
7.	牛福文, 張茂樞, 劉慶勝, 等. 關節鏡下治療肩袖鈣化性肌腱炎的近期療效. 中國修復重建外科雜志, 2013, 27(2): 245-246.
8.	劉洋, 印凡, 許兵, 等. 凍結肩的診斷與治療研究進展. 中國矯形外科雜志, 2012, 20(19): 1771-1773.
9.	Karas V, Riboh JC, Garrigues GE. Arthroscopic Management of the Stiff Shoulder. JBJS Rev, 2016, 4(4): e21-27.
10.	Mehta SS, Singh HP, Pandey R. Comparative outcome of arthroscopic release for frozen shoulder in patients with and without diabetes. Bone Joint J, 2014, 96-B(10): 1355-1358.
11.	Fernandes MR. Arthroscopic treatment of adhesive capsulitis of the shoulder with minimum follow up of six years. Acta Ortop Bras, 2015, 23(2): 85-89.
12.	李海峰, 劉玉杰, 李眾利, 等. 復發性肩關節前脫位與關節內繼發損傷的相關性研究. 中國修復重建外科雜志, 2012, 26(3): 308-312.
13.	李福鎖, 禹智波, 宋娜, 等. 肩袖間隙影像解剖及常見病變的研究進展. 現代生物醫學進展, 2015, (17): 3379-3381.
14.	Russell S, Jariwala A, Conlon R, et al. A blinded, randomized, controlled trial assessing conservative management strategies for frozen shoulder. J Shoulder Elbow Surg, 2014, 23(4): 500-507.
15.	Cho CH, Jang HK, Bae KC, et al. Clinical outcomes of rotator cuff repair with arthroscopic capsular release and manipulation for rotator cuff tear with stiffness: a matched-pair comparative study between patients with and without stiffness. Arthroscopy, 2015, 31(3): 482-487.

1. Itoi E, Arce G, Bain GI, et al. Shoulder Stiffness: Current Concepts and Concerns. Arthroscopy, 2016, 32(7): 1402-1414.
2. Garsman GM. 肩關節鏡手術學. 徐衛東, 陳世益, 陳百成, 主譯. 上海: 第二軍醫大學出版社, 2008: 139.
3. 王海明, 趙金忠, 皇甫小橋, 等. 原發性凍結肩關節鏡手術干預時機選擇對療效的影響. 中華老年醫學雜志, 2016, 35(7): 743-748.
4. Jerosch J, Nasef NM, Peters O, et al. Mid-term results following arthroscopic capsular release in patients with primary and secondary adhesive shoulder capsulitis. Knee Surg Sports Trauma, 2013, 21(5): 1195-1202.
5. Grant JA, Schroeder N, Miller BS, et al. Comparison of manipulation and arthroscopic capsular release for adhesive capsulitis: a systematic review. J Shoulder Elbow Surg, 2013, 22(8): 1135-1145.
6. Thompson SR, Lebel ME. Use of a hip arthroscopy flexible radiofrequency device for capsular release in frozen shoulder. ArthroscTech, 2012, 1(1): e75-78.
7. 牛福文, 張茂樞, 劉慶勝, 等. 關節鏡下治療肩袖鈣化性肌腱炎的近期療效. 中國修復重建外科雜志, 2013, 27(2): 245-246.
8. 劉洋, 印凡, 許兵, 等. 凍結肩的診斷與治療研究進展. 中國矯形外科雜志, 2012, 20(19): 1771-1773.
9. Karas V, Riboh JC, Garrigues GE. Arthroscopic Management of the Stiff Shoulder. JBJS Rev, 2016, 4(4): e21-27.
10. Mehta SS, Singh HP, Pandey R. Comparative outcome of arthroscopic release for frozen shoulder in patients with and without diabetes. Bone Joint J, 2014, 96-B(10): 1355-1358.
11. Fernandes MR. Arthroscopic treatment of adhesive capsulitis of the shoulder with minimum follow up of six years. Acta Ortop Bras, 2015, 23(2): 85-89.
12. 李海峰, 劉玉杰, 李眾利, 等. 復發性肩關節前脫位與關節內繼發損傷的相關性研究. 中國修復重建外科雜志, 2012, 26(3): 308-312.
13. 李福鎖, 禹智波, 宋娜, 等. 肩袖間隙影像解剖及常見病變的研究進展. 現代生物醫學進展, 2015, (17): 3379-3381.
14. Russell S, Jariwala A, Conlon R, et al. A blinded, randomized, controlled trial assessing conservative management strategies for frozen shoulder. J Shoulder Elbow Surg, 2014, 23(4): 500-507.
15. Cho CH, Jang HK, Bae KC, et al. Clinical outcomes of rotator cuff repair with arthroscopic capsular release and manipulation for rotator cuff tear with stiffness: a matched-pair comparative study between patients with and without stiffness. Arthroscopy, 2015, 31(3): 482-487.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of arthroscopic capsular release to treat primary severe frozen shoulder through trans cuff portal

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