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. 肩关节镜手术学. 徐卫东, 陈世益, 陈百成, 主译. 上海: 第二军医大学出版社, 2008: 139.
3.	王海明, 赵金忠, 皇甫小桥, 等. 原发性冻结肩关节镜手术干预时机选择对疗效的影响. 中华老年医学杂志, 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, 张茂枢, 刘庆胜, 等. 关节镜下治疗肩袖钙化性肌腱炎的近期疗效. 中国修复重建外科杂志, 2013, 27(2): 245-246.
8.	刘洋, 印凡, 许兵, 等. 冻结肩的诊断与治疗研究进展. 中国矫形外科杂志, 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, 刘玉杰, 李众利, 等. 复发性肩关节前脱位与关节内继发损伤的相关性研究. 中国修复重建外科杂志, 2012, 26(3): 308-312.
13.	李福锁, 禹智波, 宋娜, 等. 肩袖间隙影像解剖及常见病变的研究进展. 现代生物医学进展, 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. 肩关节镜手术学. 徐卫东, 陈世益, 陈百成, 主译. 上海: 第二军医大学出版社, 2008: 139.
3. 王海明, 赵金忠, 皇甫小桥, 等. 原发性冻结肩关节镜手术干预时机选择对疗效的影响. 中华老年医学杂志, 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, 张茂枢, 刘庆胜, 等. 关节镜下治疗肩袖钙化性肌腱炎的近期疗效. 中国修复重建外科杂志, 2013, 27(2): 245-246.
8. 刘洋, 印凡, 许兵, 等. 冻结肩的诊断与治疗研究进展. 中国矫形外科杂志, 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, 刘玉杰, 李众利, 等. 复发性肩关节前脱位与关节内继发损伤的相关性研究. 中国修复重建外科杂志, 2012, 26(3): 308-312.
13. 李福锁, 禹智波, 宋娜, 等. 肩袖间隙影像解剖及常见病变的研究进展. 现代生物医学进展, 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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