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Long-Term Outcomes After Arthroscopic Capsular Release for Idiopathic Adhesive Capsulitis
Hugh M.J. Le Lievre1; George A.C. Murrell, MD, DPhil1
1 Orthopaedic Research Institute, St George Hospital, Level 2, 4-10 South Street, Kogarah NSW 2217, Australia. E-mail address for G.A.C. Murrell: murrell.g@ori.org.au
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Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

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Orthopaedic Research Institute, St George Hospital, Level 2, 4-10 South Street, Kogarah NSW 2217, Australia. E-mail address for G.A.C. Murrell: murrell.g@ori.org.au
Investigation performed at the Orthopaedic Research Institute, St George Hospital Campus, University of New South Wales, Kogarah, New South Wales, Australia

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2012 Jul 03;94(13):1208-1216. doi: 10.2106/JBJS.J.00952
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Abstract

Background: 

One management strategy for the treatment of idiopathic adhesive capsulitis, or frozen shoulder, is arthroscopic capsular release. While there are long-term data regarding nonoperative treatment and good short-term outcomes following a release for idiopathic adhesive capsulitis, little is known about the outcomes five years or more after arthroscopic capsular release.

Methods: 

Patients with idiopathic adhesive capsulitis treated with a circumferential arthroscopic capsular release of the glenohumeral joint by a single surgeon were assessed with use of patient-reported pain scores, shoulder functional scores with use of a Likert scale, and shoulder range of motion at the preoperative evaluation and at one, six, twelve, twenty-four, and fifty-two weeks and a mean of seven years after surgery.

Results: 

At a mean follow-up of seven years (range, five through thirteen years), forty-three patients (forty-nine shoulders) had significant improvement with regard to pain frequency and severity, patient-reported shoulder function, stiffness, and difficulty in completing activities compared with the findings at the initial presentation (p < 0.001) and the one-year follow-up evaluation (p < 0.01 to p < 0.001). Shoulder motion also improved (p < 0.001) and was comparable with that of the contralateral shoulder. There were no complications.

Conclusions: 

Patients with idiopathic adhesive capsulitis treated with an arthroscopic capsular release had early significant improvements in shoulder range of motion, pain frequency and severity, and function. These improvements were maintained and/or enhanced at seven years. In contrast to results reported for nonoperative treatment, shoulder range of motion at seven years was equivalent to that in the contralateral shoulder.

Level of Evidence: 

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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