[Arthroscopic capsular release in the management of refractory adhesive capsulitis. Technique and results]

Idiopathic adhesive capsulitis can severely restrict the comfort and function of the entire extremity, often resulting in prolonged, substantial disability. Some studies have demonstrated long-term residual pain and limitation of motion in most patients after conservative treatment such as physical therapy or corticoid injection. Closed manipulation is associated with severe complications. We report the technique and results of arthroscopic capsular release as an effective and safe alternative for the management of refractory adhesive capsulitis. We operated 23 patients between June 2003 and November 2004 who suffered from a loss of glenohumeral motion in all planes arthroscopically. Ten of the patients were evaluated after a mean follow-up of 6 months. We found significant pain relief a few days after surgery in every patient. Furthermore, we found improvements in the range of motion in all planes. Abduction improved from preoperative 50 degrees to postoperative 120 degrees , flexion from 55 degrees to 120 degrees, external rotation from 10 degrees to 60 degrees and internal rotation from 20 degrees to 65 degrees. The average Constant Score improved from preoperative 32 to postoperative 81 points. Arthroscopic capsular release is an effective and safe technique for the management of refractory adhesive capsulitis, avoiding prolonged disability.