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‘Excellent’ outcomes with arthroscopic 360° capsular release for idiopathic adhesive capsulitis
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Results from a recently published study demonstrated arthroscopic 360° capsular release in the lateral decubitus position yielded significant and lasting improvements in range of motion, ‘excellent’ functional outcomes, low revision and complication rates in patients with idiopathic adhesive capsulitis.
“Arthroscopic 360° capsular release in the lateral decubitus position for idiopathic adhesive capsulitis in patients who failed nonoperative treatment leads to significant early and lasting improvement in range of motion, excellent functional outcomes, and low revision and complication rates,” Gregory L. Cvetanovich, MD, told Healio.com/Orthopedics. “Performing this technique in the lateral decubitus position enables enhanced visualization and access to the inferior capsule so that the entire capsule can be released without manipulation under anesthesia.”
Cvetanovich and colleagues performed a retrospective case series of 43 patients who underwent arthroscopic capsular release in the lateral decubitus position for idiopathic adhesive capsulitis. The minimum follow-up was 2 years. Investigators recorded patient demographics, preoperative and postoperative range of motion, postoperative outcome scores, VAS for pain, Single Assessment Numeric Evaluation, Simple Shoulder Test and American Shoulder and Elbow Surgeons scores. After noting complications and reoperations in 10 patients, the researchers excluded this group due to post-traumatic etiology..
Investigators noted of the 33 patients remaining, 27 completed the minimum 2-year follow-up. Results showed hypothyroid in 7% of patients and diabetes in 30%. At the final follow-up, investigators saw improvements in active forward flexion, from 115° to 156.2°. Active external rotation with arm adducted also improved from 28.1° to 56.8° preoperatively to the final follow-up. There were improvements in ROM seen as early as 2 weeks after surgery. Two patients had manipulation under anesthesia after surgery because of early recurrent stiffness between 4 to 6 weeks after arthroscopic capsular release. Researchers did not observe revision surgeries or complications. – by Monica Jaramillo
Disclosures: Cvetanovich reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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