Frozen shoulder--comparison of different surgical treatment options

In this study data from 54 patients with persisting primary frozen shoulder were collected and evaluated retrospectively. All included patients underwent a specific kind of surgical treatment of the shoulder. Three different surgical techniques were compared to each other. A group of 21 patients received a combination of arthroscopic capsular release and subacromial decompression. 18 patients were treated by subacromial decompression combined with mobilization under anesthesia and 15 patients underwent selective arthroscopic capsular release. We evaluated glenohumeral range of motion in every patient pre-and postoperatively. The investigated directions of motion were abduction, flexion and external rotation. The collected results were compared statistically. The mean follow-up of the treated patients was 37 weeks (range 11-52 weeks). All three surgical treatments improved the range of movement in every glenohumeral direction significantly. They achieved equal improvements in abduction and flexion. Regarding external rotation selective arthroscopic capsular release revealed not significantly better results than the other two surgical treatments, but there was a trend towards significance (p-value 0.0694). This study showed that all performed surgical techniques improved ranges of movement in the glenohumeral joint in patients with persistent frozen shoulder. Arthroscopic capsular release, alone or with subacromial decompression, is a safe procedure and showed the best results postoperatively. In our opinion arthroscopic capsular release should be recommended as the first choice treatment in persistent frozen shoulder.