Volume 5 | Issue 2 | September-December 2020 | Page 07-12 | Abdul Azeem Badurudeen, Balaji Sambandam
Author: Abdul Azeem Badurudeen , Balaji Sambandam 
 Department of Orthopaedics, Institute of Medical Sciences, Melmaruvathur, Tamilnadu, India.
 Department of Orthopaedics, Atlas Hospital, Trichy, Tamilnadu, India.
Address of Correspondence:
Dr. Balaji Sambandam,
Orthopaedic Consultant, Atlas Hospital, Trichy, Tamilnadu, India.
Background: Adhesive capsulitis is one of the commonest disabling problem of the shoulder. Management of this pathology has multiple conservative and surgical options. Among the surgical options arthroscopic capsular release is the most researched technique. The aim of this study is to find the relevance of the procedure in current practice, by systematically reviewing the recent literatures.
Methods: A rigorous online data search was done for scientific English publications between 2000 and 2020. Search engines used were Medline, Google scholar and Cochrane. Keywords used were shoulder stiffness, adhesive capsulitis, frozen shoulder, capsular release and shoulder arthroscopy. Inclusion criteria were original studies, minimum sample size of 10 patients, arthroscopic capsular release as one of the treatment modalities, minimum follow up duration of 6 months, minimum duration of symptoms of 3 months. Studies with secondary adhesive capsulitis, additional procedures such as rotator cuff repairs were excluded from this review. All articles were evaluated by both the authors and data were extracted and analyzed.
Results: Twenty articles met with all inclusion criteria. There were 10 prospective and 10 retrospective studies. Two were level 2 studies, four were level 3 studies and 14 were level 4 studies. Total of 797 patients (810 shoulder) underwent arthroscopic capsular release. The average age was 52. 285 were males. 466 were females. 205 were right shoulders. 204 were left shoulders. Average follow up was 20.25 months. Arthroscopic capsular release resulted in significant improvement in range of motion at all planes and reduced VAS scores. There was a significant improvement in post-operative shoulder functional outcome scores. Complication rate was 3.1%, but none of them were major and recurrence rate was 0.25%.
Conclusion: Arthroscopic capsular release is a very good option for adhesive capsulitis with failed conservative treatment. It results in a significant improvement in range of motion and functional outcome scores. Good result of arthroscopic capsular release was observed very quickly and was maintained in long term. It is a very safe procedure with very minimal complication.
Keywords: Periarthritis; Adhesive capsulitis; Frozen shoulder; Arthroscopic capsular release; Shoulder arthroscopy.
- Lafosse L, Boyle S, Kordasiewicz B, Aranberri-Gutiérrez M, Fritsch B, Meller R. Arthroscopic arthrolysis for recalcitrant frozen shoulder: a lateral approach. Arthroscopy. 2012 Jul;28(7):916-23.
- Neviaser JS. Adhesive capsulitis of the shoulder. J Bone Joint Surg Am. 1945;27:211–22.
- Tasto JP, Elias DW.Adhesive Capsulitis. Sports Med Arthrosc Rev. 2007;15:216–21.
- Le Lievre HMJ, Murrell GAC. Long-Term Outcomes After Arthroscopic Capsular Release for Idiopathic Adhesive Capsulitis. J Bone Joint Surg Am. 2012;94:1208-16.
- Fernandes MR. Arthroscopic treatment of adhesive capsulitis of the shoulder with minimum follow up of six years. Acta Ortop Bras. 2015;23(2):85-9.
- Redler LH, Dennis ER. Treatment of Adhesive Capsulitis of the Shoulder. J Am Acad Orthop Surg. 2019;27: e544-e554.
- Berghs BM, Sole-Molins X, Bunker TD. Arthroscopic release of adhesive capsulitis. Journal of shoulder and elbow surgery.2004;13(2):180-5.
- Cvetanovich GL, Leroux T, Hamamoto JT, Higgins JD, Romeo AA, Verma NN. Arthroscopic 360◦ Capsular Release for Adhesive Capsulitis in the Lateral Decubitus Position. Arthrosc Tech. 2016;5(5):e1033-e1038.
- Barnes CP, Lam PH, Murrell GAC. Short-term outcomes after arthroscopic capsular release for adhesive capsulitis. J shoulder and elbow surgery; 2016 Sep;25(9):e256-264.
- Mukherjee RN, Pandey RM, Nag HL, Mittal R. Frozen shoulder – A prospective randomized clinical trial. World J Orthop. 2017; 8(5): 394-9.
- Gallacher S, Beazley JC, Evans J et al. A randomized controlled trial of arthroscopic capsular release versus hydrodilatation in the treatment of primary frozen shoulder. J Shoulder Elbow Surg. 2018 Aug;27(8):1401-6.
- Walther M, Blanke F, Wehren LV, Majewski M. Frozen Shoulder – Comparison of different surgical treatment options. Acta Orthop. Belg. 2014;80:172-7.
- De Carli A, Vadalà A, Perugia D et al. Shoulder adhesive capsulitis: manipulation and arthroscopic arthrolysis or intra-articular steroid injections. International Orthopaedics (SICOT). 2012;36:101–6.
- Rill BK, Fleckenstein CM, Levy MS, Nagesh V, Hasan SS. Predictors of outcome after nonoperative and operative treatment of adhesive capsulitis. Am J Sports Med. 2011 Mar;39(3):567-74.
- Massoud SN, Pearse EO, Levy O, Copeland SA. Operative management of the frozen shoulder in patients with diabetes. J Shoulder Elbow Surg. 2002;11(6):609-13.
- Tsai MJ, Ho WP, Chen CH, Leu TH, Chuang TY. Arthroscopic extended rotator interval release for treating refractory adhesive capsulitis: A viewpoint of “mobilizing subscapularis.” Journal of Orthopaedic Surgery. 2017;25(1);1-7.
- Mubark IM, Ragab AH, Nagi AA, Motawea BA. Evaluation of the results of management of frozen shoulder using the arthroscopic capsular release. Ortop Traumatol Rehabil. 2015;17(1):21-8.
- Waszczykowski M, Polguj M, Fabiś J. The impact of arthroscopic capsular release in patients with primary frozen shoulder on shoulder muscular strength. Biomed Res Int. 2014;2014:834283.
- Smith CD, Hamer P, Bunker TD. Arthroscopic capsular release for idiopathic frozen shoulder with intra-articular injection and a controlled manipulation. Ann R Coll Surg Engl. 2014;96(1):55-60.
- Dattani R, Ramasamy V, Parker R, Patel VR. Improvement in quality of life after arthroscopic capsular release for contracture of the shoulder. Bone Joint J. 2013 Jul;95-B(7):942-6.
- Baums MH, Spahn G, Nozaki M, Steckel H, Schultz W, Klinger HM. Functional outcome and general health status in patients after arthroscopic release in adhesive capsulitis. Knee Surg Sports Traumatol Arthrosc. 2007;15(5):638–44.
- Klinger HM, Otte S, Baums MH, Haerer T Early arthroscopic release in refractory shoulder stiffness. Arch Orthop Trauma Surg. 2002;122:200–3.
- Ranalletta M, Rossi LA, Zaidenberg EE et al. Midterm Outcomes After Arthroscopic Anteroinferior Capsular Release for the Treatment of Idiopathic Adhesive Capsulitis. The Journal of Arthroscopic and Related Surgery. 2017;33(3):503-8.
- Puah KL, Salieh MS, Yeo W, Tan AHC. Outcomes of arthroscopic capsular release for the diabetic frozen shoulder in Asian patients. J Orthop Surg (Hong Kong). 2018;26(1):1-4.
- Jerosch J. 360 degrees arthroscopic capsular release in patients with adhesive capsulitis of the glenohumeral joint–indication, surgical technique, results. Knee Surg Sports Traumatol Arthrosc. 2001;9(3):178-86.
- Uno A, Bain G, Mehta J. Arthroscopic relationship of the axillary nerve to the shoulder joint capsule: An anatomic study.J Shoulder Elbow Surg 1999; 8: 226-30.
|How to Cite this article: Badurudeen AA, Sambandam B | Arthroscopic Capsular Release of Adhesive Capsulitis- A Systematic Review | Asian Journal of Arthroscopy | September-December 2020; 5(2): 07-12.|