Arthroscopic Capsular Release of Adhesive Capsulitis- A Systematic Review

Volume 5 | Issue 2 | September-December 2020 | Page 07-12 | Abdul Azeem Badurudeen, Balaji Sambandam

Author: Abdul Azeem Badurudeen [1], Balaji Sambandam [2]

[1] Department of Orthopaedics, Institute of Medical Sciences, Melmaruvathur, Tamilnadu, India.
[2] Department of Orthopaedics, Atlas Hospital, Trichy, Tamilnadu, India.

Address of Correspondence:
Dr. Balaji Sambandam,
Orthopaedic Consultant, Atlas Hospital, Trichy, Tamilnadu, India.
E-mail: balajinimrotz@gmail.com

Abstract

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.

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