What question did this study set out to answer?

To evaluate the efficacy, functional outcomes, and safety of arthroscopic anterior capsular release in patients with chronic adhesive capsulitis unresponsive to conservative care.

December 1, 1996Journal of Bone and Joint Surgery

Arthroscopic Release for Chronic, Refractory Adhesive Capsulitis of the Shoulder*

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Idiopathic adhesive capsulitis (n=23). Intervention: Arthroscopic anterior capsular release vs. Preoperative values. Primary outcome: Improvement in the score of Constant and Murley (MD 48, p=<0.01).

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Key result

Arthroscopic capsular release significantly improved motion and Constant and Murley scores (mean improvement 48 points) compared to preoperative values in refractory adhesive capsulitis (p<0.01).

Why the study?

Does arthroscopic capsular release improve motion and functional scores in patients with refractory idiopathic adhesive capsulitis?

Key Points

To evaluate the efficacy, functional outcomes, and safety of arthroscopic anterior capsular release in patients with chronic adhesive capsulitis unresponsive to conservative care.
Treated 23 patients with refractory idiopathic adhesive capsulitis who failed physical therapy or closed manipulation over a three-year period.
Performed arthroscopic anterior capsular release (with adjunctive acromioplasty in 6 patients) followed by 48 hours of intensive inpatient physical therapy under interscalene regional analgesia and subsequent outpatient rehabilitation.
Evaluated shoulder range of motion and Constant and Murley scores at a mean follow-up of 39 months (range, 24 to 64 months).
Constant and Murley scores improved by a mean of 48 points (range, 13 to 77 points) with zero procedural complications.
Shoulder motion improved significantly across all planes (p < 0.01), including flexion (+49°), external rotation (+42° in adduction, +53° in abduction), and internal rotation (+8 spinous levels, +33° in abduction).
Postoperative range of motion restored mobility to within a mean of 7° of the contralateral, healthy shoulder.

Study Design

Type

Observational (n=23)

Structured PICO

Does arthroscopic capsular release improve motion and functional scores in patients with refractory idiopathic adhesive capsulitis?

Population

23 patients with idiopathic adhesive capsulitis refractory to physical therapy or closed manipulation, treated with arthroscopic capsular release and followed for a mean of 39 months.

Exposure

Arthroscopic anterior capsular release followed by 48 hours of intensive inpatient physical therapy with interscalene regional analgesia, and supervised outpatient physical therapy

Outcome

Improvement in the score of Constant and Murley and improvement in shoulder motion (flexion, external rotation, internal rotation) at a mean of 39 monthspatient reported

Main Result

Mean Difference: 48

p-value: p=<0.01

Arthroscopic capsular release reliably improves motion and functional scores with little operative morbidity in patients with refractory adhesive capsulitis.

Authors

JWJon J.P. WarnerMedical Protective AAAnsworth A. AllenHospital for Special Surgery PMPaul MarksSunnybrook Health Science Centre

Discussion

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Implication

May warrant consideration in refractory cases; hypothesis-generating and requires randomized trials before practice change.

Cite This Study

Warner et al. (1996) conducted an observational in Idiopathic adhesive capsulitis (n=23). Arthroscopic anterior capsular release vs. Preoperative values was evaluated on Improvement in the score of Constant and Murley (MD 48, p=<0.01). Arthroscopic capsular release significantly improved motion and Constant and Murley scores (mean improvement 48 points) compared to preoperative values in refractory adhesive capsulitis (p<0.01).

synapsesocial.com/papers/6a93e9c68e5b8037ce43e595 https://doi.org/10.2106/00004623-199612000-00003

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Arthroscopic Release for Chronic, Refractory Adhesive Capsulitis of the Shoulder*

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Arthroscopic Release for Chronic, Refractory Adhesive Capsulitis of the Shoulder*

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Also Consider