Related Experiment Video
Updated: Nov 10, 2025
Rat Model of Adhesive Capsulitis of the Shoulder
Published on: September 28, 2018
Is routine gleno-humeral exploration a risk factor for adhesive capsulitis after arthroscopic removal of rotator cuff
Alexandre Ecalle1, Clément Julien2, Samir Chaouche3
1Service de chirurgie orthopédique, hôpital d'Instruction des Armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France; Service de chirurgie orthopédique, Clinique Monticelli-Vélodrome Groupe RGDS (Ramsay Générale de Santé), 10, allée Marcel-Leclerc, 13008 Marseille, France; Service de chirurgie orthopédique, Nouvelle Clinique de La Ciotat, groupe ESM (Établissements Sainte Marguerite), boulevard Lamartine, 13600 La Ciotat, France.
Background:
Arthroscopic surgery has earned its place as the reference standard treatment for rotator cuff calcific tendinopathy refractory to conservative medical treatment. Adhesive capsulitis of the shoulder is the most common complication (12%). Standard practice involves routine gleno-humeral exploration before calcification removal. The objective of this study was to identify risk factors for adhesive capsulitis.
Hypothesis:
The development of adhesive capsulitis is associated with gleno-humeral exploration.
Methods:
We conducted a multicentre, multi-surgeon, retrospective cohort study of 340 consecutive patients who underwent arthroscopic removal of rotator cuff calcifications between 1 January 2012 and 1 January 2018. We collected epidemiological data (age, sex, work-related physical activity), the history of previous treatments (local injections, needling), the type and location of the calcifications as assessed radiologically, the clinical findings (Constant score before and 6 months after surgery, diagnosis of adhesive capsulitis defined as shoulder pain with motion range limitation in all directions), and the surgical details (type of anaesthesia, gleno-humeral exploration).
Results:
Of the 340 patients, 251 underwent routine gleno-humeral exploration and 89 did not. Adhesive capsulitis developed in 40 (12%) patients. By multivariate analysis, gleno-humeral exploration was an independent risk factor for adhesive capsulitis (p=0.022; odds ratio, 5.60). Of the 251 gleno-humeral explorations, 8% identified concomitant lesions and only 4% led to a curative procedure.
Conclusion:
Given our results and the data in the literature, we believe that routine gleno-humeral exploration during the arthroscopic treatment of rotator cuff calcific tendinopathy is inadvisable.
Level Of Evidence:
III; case-control study.
