Keywords
arthroscopic capsular release
shoulder joint
stiffness
How to Cite
Abstract
Background. Most of our colleagues, upon discovering injuries to the glenoid labrum or other soft tissue structures of the shoulder joint in a patient, perform surgical interventions without paying attention to changes in its capsule. Objective: to compare the treatment outcomes of patients with shoulder contracture who underwent arthroscopic capsular release with re-fixation of the glenoid labrum versus those who underwent only re-fixation of the glenoid labrum.
Materials and methods: The study included 98 patients with shoulder joint stiffness and glenoid labrum injury. The patients were divided into two groups: group 1 underwent re-fixation of the glenoid labrum and arthroscopic capsular release, while group 2 underwent re-fixation of the glenoid labrum without arthroscopic capsular release.
Results: Three months after the operation, in group 2, the mean functional outcome according to the Constant Shoulder Score scale was slightly worse than in group 1 and ranged from 14.5 ± 6.2 points, while in group 1, the mean functional outcome was 8.5 ± 6 points (p = 0.031). Six months after the operation, in group 1, the mean functional outcome according to the Constant Shoulder Score scale was 5.1 ± 5.6 points, while in group 2, it was 10.1 ± 4.1 points (p = 0.024). Conclusion: The results of treating patients with secondary shoulder stiffness who underwent arthroscopic capsular release and fixation of the glenoid labrum were better according to the Constant Shoulder Score and the VAS scale at both 3 and 6 months after the operation than the results of treating patients who underwent only fixation of the glenoid labrum without arthroscopic capsular release.
References
Ch.A.Rockwood, F.A.Masten. Rockwood and Matsen's The Shoulder sixth edition. – Elsevier, 2022. – 1386 p. eBook ISBN: 9780323698368
Lancaster ST, Grove TN, Woods DA. Management of posttraumatic stiffness of the shoulder following upper limb trauma with manipulation under anaesthetic. Shoulder Elbow. 2017;9:258-265. doi: 10.1177/1758573217693974
Itoi E, Arce G, Bain GI, et al. Shoulder stiffness: current concepts and concerns. Arthroscopy. 2016;32:1402-1414. doi: 10.1016/j.arthro.2016.03.024
McNamara WJ, Lam PH, Murrell GA. The relationship between shoulder stiffness and rotator cuff healing: a study of 1,533 consecutive arthroscopic rotator cuff repairs. J Bone Joint Surg Am. 2016;98:1879-1889. doi: 10.2106/ JBJS.15.00923
Kim JH, Ha DH, Kim SM, et al. Does arthroscopic preemptive extensive rotator interval release reduce postoperative stiffness after arthroscopic rotator cuff repair? A prospective randomized clinical trial. J Shoulder Elbow Surg. 2019. 28:1639-1646. doi: 10.1016/j.jse.2019.05.021
Ricchetti ET. Editorial commentary: in search of the optimal diagnostic tool for periprosthetic joint infections of the shoulder. Arthroscopy. 2019;35:2578-2580. doi: 10.1016/j.arthro.2019.05.004
Elhassan B, Ozbaydar M, Massimini D, et al. Arthroscopic capsular release for refractory shoulder stiffness: a critical analysis of effectiveness in specific etiologies. J Shoulder Elbow Surg. 2010;19:580-587. doi: 10.1016/j.jse.2009.08.004.
Ando A, Sugaya H, Hagiwara Y, et al. Identification of prognostic factors for the nonoperative treatment of stiff shoulder. Int Orthop. 2013;37:859-864. doi: 10.1007/s00264013-1859-8
Denard PJ, Ladermann A, Burkhart SS. Prevention and management of stiffness after arthroscopic rotator cuff repair: systematic review and implications for rotator cuff healing. Arthroscopy. 2011;27:842-848. doi: 10.1016/j.arthro.2011.01.013.
Chung SW, Huong CB, Kim SH, et al. Shoulder stiffness after rotator cuff repair: risk factors and influence on outcome. Arthroscopy. 2013;29:290-300. doi: 10.1016/j.arthro.2012.08.023.
Itoi, E., Arce, G., Bain, G. I. et al. Shoulder stiffness: Current concepts and concerns. Springer, 2015. – 241 p. https://doi. org/10.1007/978-3-662-46370-3
J.Ramirez Adhesive capsulitis: Diagnosis and Management Am Fam Physician. 2019; 99(5):297-300. PMID: 30811157
Park JY, Pandher DS, Moon GH, Yoo MJ, Lee ST. Comparison of surgical outcome in impingement syndrome with and without stiff shoulder. Indian J Orthop. 2008;42:182-187. doi: 10.4103/0019-5413.40255.
Chung SW, Oh JH, Gong HS, Kim JY, Kim SH. Factors affecting rotator cuff healing after arthroscopic repair: osteoporosis as one of the independent risk factors. Am J Sports Med. 2011;39:2099-2107. doi: 10.1177/0363546511415659.
S. Sabzevari, A. R. Kachooei, J. Giugale, A. Lin One-stage surgical treatment for concomitant rotator cuff tears with shoulder stiffness has comparable results with isolated rotator cuff tears: a systematic review. J Shoulder Elbow Surg 2017 Aug;26(8):e252-e258. doi: 10.1016/j.jse.2017.03.005.
Elhassan B, Ozbaydar M, Massimini D, et al. Arthroscopic capsular release for refractory shoulder stiffness: a critical analysis of effectiveness in specific etiologies. J Shoulder Elbow Surg. 2010;19:580-587. doi: 10.1016/j.jse.2009.08.004.
Ebrahimzadeh MH, Moradi A, Bidgoli HF, Zarei B. The relationship between depression or anxiety symptoms and objective and subjective symptoms of patients with frozen shoulder. Int J Prev Med. 2019;10:38. doi: 10.4103/ijpvm. IJPVM_212_17
Fields BKK, Skalski MR, Patel DB, et al. Adhesive capsulitis: review of imaging findings, pathophysiology, clinical presentation, and treatment options. Skeletal Radiol. 2019;48(8):1171-1184. doi: 10.1007/s00256-018-3139-6.
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