scholarly journals Early Clinical Outcomes of Manipulation under Anesthesia for Refractory Adhesive Capsulitis: Comparison with Arthroscopic Capsular Release

2020 ◽  
Vol 12 (2) ◽  
pp. 217
Author(s):  
Du-Han Kim ◽  
Kwang-Soon Song ◽  
Byung-Woo Min ◽  
Ki-Choer Bae ◽  
Young-Jae Lim ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Adhesive Capsulitis ◽  
Manipulation Under Anesthesia ◽  
Capsular Release ◽  
Arthroscopic Capsular Release ◽  
Early Clinical Outcomes

scholarly journals Can manipulation under anesthesia alone provide clinical outcomes similar to arthroscopic circumferential capsular release in primary frozen shoulder (FS)?: the necessity of arthroscopic capsular release in primary FS

2020 ◽  
Vol 23 (4) ◽  
pp. 169-177
Author(s):  
Seung-Jin Lee ◽  
Jun-Hyuk Jang ◽  
Yoon-Suk Hyun
Keyword(s):  
Clinical Outcomes ◽  
Frozen Shoulder ◽  
Manipulation Under Anesthesia ◽  
Steroid Injections ◽  
Treatment Groups ◽  
Capsular Release ◽  
Arthroscopic Capsular Release ◽  
Group A ◽  
Shoulder Motion ◽  
Group B

Background: We evaluated the need for arthroscopic capsular release (ACR) in refractory primary frozen shoulder (FS) by comparing clinical outcomes of patients treated with ACR and manipulation under anesthesia (MUA). Methods: We assessed patients with refractory primary FS, 54 patients (group A) who were treated with MUA and 22 patients (group B) who were treated with ACR. In group A, manipulation including a backside arm-curl maneuver was performed under interscalene brachial block. In group B, manipulation was performed only to release the inferior capsule before arthroscopic circumferential capsular release, which was carried out for the unreleased capsule after manipulation. Pain, range of shoulder motion, and American Shoulder and Elbow Society score were recorded at 1 week, 3 months, 6 months, and 1 year after surgery. We compared outcome variables between treatment groups and between diabetics and non-diabetics and also evaluated the numbers of patients receiving additional intra-articular steroid injection.Results: Outcome variables at 3 months after surgery and improvements in outcome variables did not differ between groups. Group A showed significantly better results than group B in the evaluation of pain and range of motion at 1 week. Diabetics showed comparable outcomes to non-diabetics for most variables. Eleven patients required additional steroid injections between 8 to 16 weeks after surgery: 12.2% in group A, 18.2% in group B. Additional injections were given three times more often in diabetics compared to non-diabetics.Conclusions: MUA alone can yield similar clinical outcomes to ACR in refractory FS.

scholarly journals Outcomes of Arthroscopic Capsular Release in the Beach-Chair Versus Lateral Decubitus Position: A Systematic Review

2019 ◽  
Vol 7 (12) ◽  
pp. 232596711988817 ◽  
Author(s):  
Darby A. Houck ◽  
John W. Belk ◽  
Armando F. Vidal ◽  
Eric C. McCarty ◽  
Jonathan T. Bravman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Cochrane Library ◽  
Recurrence Rates ◽  
Capsular Release ◽  
Arthroscopic Capsular Release ◽  
Patient Reported ◽  
Lateral Decubitus ◽  
Beach Chair

Background: Arthroscopic capsular release (ACR) for the treatment of adhesive capsulitis of the shoulder can be performed in either the beach-chair (BC) or lateral decubitus (LD) position. Purpose: To determine the clinical outcomes and recurrence rates after ACR in the BC versus LD position. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed by searching PubMed, Embase, and the Cochrane Library databases for studies reporting clinical outcomes of patients undergoing ACR in either the BC or LD position. All English-language literature from 1990 through 2017 reporting on clinical outcomes after ACR with a minimum 3-month follow-up were reviewed by 2 independent reviewers. Recurrence rates, range of motion (ROM) results, and patient-reported outcome (PRO) scores were collected. Study methodological quality was evaluated using the modified Coleman Methodology Score (MCMS). Results: A total of 30 studies (3 level 1 evidence, 2 level 2 evidence, 4 level 3 evidence, 21 level 4 evidence) including 665 shoulders undergoing ACR in the BC position (38.1% male; mean age, 52.0 ± 3.9 years; mean follow-up, 35.4 ± 18.4 months) and 603 shoulders in the LD position (41.8% male; mean age, 53.0 ± 2.3 years; mean follow-up, 37.2 ± 16.8 months) were included. There were no significant differences in overall mean recurrence rates between groups (BC, 2.5%; LD, 2.4%; P = .81) or in any PRO scores between groups ( P > .05). There were no significant differences in improvement in ROM between groups, including external rotation at the side (BC, 36.4°; LD, 42.8°; P = .91), forward flexion (BC, 64.4°; LD, 79.3°; P = .73), abduction (BC, 77.8°; LD, 81.5°; P = .82), or internal rotation in 90° of abduction (BC, 40.8°; LD, 45.5°; P = .70). Significantly more patients in the BC group (91.6%) underwent concomitant manipulation than in the LD group (63%) ( P < .0001). There were significantly more patients with diabetes in the LD group (22.4%) versus the BC group (9.6%) ( P < .0001). Conclusion: Low rates of recurrent shoulder stiffness and excellent improvements in ROM can be achieved after ACR in either the LD or BC position. Concomitant manipulation under anesthesia is performed more frequently in the BC position compared with the LD position.

Functional Outcome After Arthroscopic Capsular Release in Management of the Shoulder Adhesive Capsulitis

2021 ◽  
Vol 85 (1) ◽  
pp. 3166-3172
Author(s):  
Elias Emhemed Yousef Alazabi ◽  
Adel Mohammad Salama ◽  
Mohmed A. Abdel Salam ◽  
Hany Mohamed Abd Elfattah Bakr
Keyword(s):  
Functional Outcome ◽  
Adhesive Capsulitis ◽  
Capsular Release ◽  
Arthroscopic Capsular Release

Short-term outcomes after arthroscopic capsular release for adhesive capsulitis

2016 ◽  
Vol 25 (9) ◽  
pp. e256-e264 ◽  
Author(s):  
Callum P. Barnes ◽  
Patrick H. Lam ◽  
George A.C. Murrell
Keyword(s):  
Adhesive Capsulitis ◽  
Short Term ◽  
Capsular Release ◽  
Arthroscopic Capsular Release

scholarly journals Current Concepts in the Treatment of adhesive capsulitis of the Shoulder

2019 ◽  
Vol 6 (03) ◽  
pp. 4354-4357
Author(s):  
Luciano Andrés Rossi ◽  
Maximiliano Ranalletta
Keyword(s):  
Corticosteroid Injection ◽  
Adhesive Capsulitis ◽  
Postoperative Rehabilitation ◽  
Duration Of Symptoms ◽  
Capsular Release ◽  
Daily Life Activities ◽  
Nonsurgical Management ◽  
Arthroscopic Capsular Release ◽  
History Of ◽  
High Level

Adhesive capsulitis is characterized by chronic inflammation of the capsular subsynovial layer, which produces capsular fibrosis, contracture, and adherence of the capsule to itself and to the anatomic neck of the humerus. Physical therapy is the mainstay of treatment, regardless of stage. Based on the natural history of the disease, early corticosteroid injection has a role in shortening the overall duration of symptoms allowing patients to move faster in the stages of rehabilitation and thus return to their daily life activities more rapidly. Most patients will see complete resolution of symptoms with nonsurgical management. In cases with refractory stiffness, manipulation under anesthesia or arthroscopic capsular release may be indicated. Because of various potential risks of complications with manipulations, arthroscopic capsular release is preferred. There is a lack of high level studies comparing different techniques for capsular release. Both circumferential and limited release have proven to be effective. Regarding postoperative rehabilitation, arthroscopic release should be followed by early, diligent, and directed therapy to prevent recurrent stiffness.

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