A comparison of two surgical methods in the treatment of shoulder adhesive capsulitis

Eur Rev Med Pharmacol Sci. 2023 Jan;27(2):467-475. doi: 10.26355/eurrev_202301_31046.

Abstract

Objective: The purpose of the study was to compare the outcomes of arthroscopic capsular release surgery and manipulation of patients with resistant primary adhesive capsulitis (AC) under anesthesia.

Patients and methods: The study comprised forty-four patients who had surgery after being given a diagnosis of primary AC. Patients who had both passive and active glenohumeral and scapulothoracic movements equal to or less than 100° elevation and less than 50% of external rotation compared to the contralateral side were considered to have resistant adhesive capsulitis and were included in the study. Conservative treatments such as intra-articular steroid injections and physical therapy had failed to relieve the pain in these patients for at least six months. The patients who took part in the trial underwent manipulation under anesthesia (group 1) and arthroscopic capsular release (group 2) operations. The chosen surgical procedure was chosen at random and based on the surgeon's preferences. examining the patients' demographic information. After treatment, the patients were examined at three-month, six-month, and one-year intervals. Joint range of motion, visual analogue scale (VAS), and Constant-Murley shoulder scores were all recorded. Statistics were used to compare the outcomes of the two surgical techniques in this study both before and after the procedure.

Results: The study's participants' gender, side, extra procedure, and age factors did not show a statistically significant difference between groups 1 and 2 (p<0.05). According to the age, gender, side, additional process, and homogeneous distribution throughout the groups. No statistically significant difference was discovered between groups 1 and 2 in any of the measurements taken from study participants during the follow-up period: Pre-op visual pain scores (VPS), Post-op 3rd month VPS, Post-op 1st year VPS, Pre-op Constant score, Post-op 6th month Constant score, and Post-op 1st year Constant score (p<0.05). The change in VPS and Constant Score values over time did not show a statistically significant difference between the groups (p<0.05). A statistically significant difference between the groups was discovered in each of the Pre-op period and Post-op 6th month VPS assessments (p<0.05).

Conclusions: Although there was no statistically significant difference between the two studied therapies, the surgical method was shown to be more beneficial in both groups the shorter the pre-op period was between the onset of the complaints and the operation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anesthesia*
  • Arthroscopy
  • Bursitis* / rehabilitation
  • Bursitis* / surgery
  • Female
  • Humans
  • Male
  • Pain, Postoperative
  • Range of Motion, Articular
  • Shoulder Joint* / surgery
  • Treatment Outcome