Arthroscopic selective capsular release in the treatment of frozen shoulder

Objectives: We evaluated the results of arthroscopic selective capsular release in patients with frozen shoulder. Methods: Sixteen patients (5 males, 11 females; mean age 51 years; range 25 to 73 years) underwent arthroscopic capsular release for frozen shoulder. The syndrome was due to trauma in two patients; nine patients had diabetes mellitus; no etiolog- ic cause was found in three patients. Two patients had rotator cuff tendinitis. The mean duration of complaints was 14 months (range 3 to 36 months). The patients were treated con¬servatively for a mean of 9.5 months (range 3 to 12 months). The range of motion of the shoulder was measured with a goniometer. Functional evaluations were made according to the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES). Under general anesthesia, all the patients underwent arthroscopic capsular release, sub- acromial bursoscopy, and manipulation. Acromioplasty was performed in two patients with subacromial impingement. The mean follow-up was 14 months (range 4 to 25 months). Results: Compared to the healthy side, postoperative incre¬ments in flexion, adduction-external rotation, abduction-inter¬nal and external rotations were 38%, 47%, 43%, and 30%, respectively. The strength of the infraspinatus, supraspinatus, and subscapularis muscles significantly increased (p<0.05). The mean postoperative ASES score improved by 50 (p<0.05). The mean visual analog scale score decreased sig¬nificantly with significant improvements in daily activities (p<0.05). Complaints of pain and limitation disappeared in a mean of 3.5 months (range 15 days-12 months) in 14 patients (87.5%) who were fully satisfied with the operation. Conclusion: Patients with frozen shoulder unresponsive to conservative treatment can be effectively treated with arthroscopic selective capsular release and manipulation.