Clinical evaluation of arthroscopic treatment of shoulder adhesive capsulitis

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• 作者：Alberto Naoki Miyazaki ; Pedro Doneux Santos ; Luciana Andrade Silva ; ^{lucalu@terra.com.br} ; Guilherme do Val Sella ; Leonardo Carrenho ; Sergio Luiz Checchia
• 关键词：Shoulder pain ; Arthroscopy ; Bursitis
• 刊名：Revista Brasileira de Ortopedia (English Edition)
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：52
• 期：1
• 页码：61-68
• 全文大小：882 K
• 卷排序：52

文摘

To evaluate the results of arthroscopic releases performed in patients with adhesive capsulitis refractory to conservative treatment.MethodsThis was a retrospective study, conducted between 1996 and 2012, which included 56 shoulders (52 patients) that underwent surgery; 38 were female, and 28 had the dominant side affected. The mean age was 51 (29–73) years. The mean follow-up was 65 (12–168) months and the mean preoperative time was 8.9 (2–24) months. According to Zukermann's classification, 23 cases were considered primary and 33 secondary. With the patient in the lateral decubitus position, circumferential release of the joint capsule was performed: joint debridement; rotator interval opening; coracohumeral ligament release; anterior, posterior, inferior, and finally antero-inferior capsulotomy. A subscapularis tenotomy was performed when necessary. All patients underwent intense physical therapy in the immediate postoperative period. In 33 shoulders, an interscalene catheter was implanted for anesthetic infusion. Functional results were evaluated by the UCLA criteria.ResultsImproved range of motion was observed: mean increase of 45° of elevation, 41° of external rotation and eight vertebral levels of medial rotation. According to the UCLA score excellent results were obtained in 25 (45%) patients; good, in 24 (45%); fair, in two (3%); and poor, in two (7%). Patients who had undergone inferior capsulotomy achieved better results. Only 8.8% of patients who used the anesthetic infusion catheter underwent postoperative manipulation. Seven patients had complications.ConclusionThere was improvement in pain and range of motion. Inferior capsulotomy leads to better results. The use of the interscalene infusion catheter reduces the number of re-approaches.