Effects of joint capsular release on range of motion in patients with frozen shoulder

Yoshihiro Hagiwara, Kenji Kanazawa, Akira Ando, Takuya Sekiguchi, Masashi Koide, Yutaka Yabe, Kazuaki Suzuki, Eiji Itoi

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background: A thickened joint capsule is believed to be one of the most specific manifestations of and the primary restraint against range of motion (ROM) in frozen shoulders. The purpose of this study was to evaluate the relationship among ROMs under general anesthesia before surgery and the effects of each joint capsular release on ROM. Methods: ROM was measured using a goniometer with scapular fixation. Arthroscopic pan-capsular release was performed with the patient in the beach-chair position in the following order: (1) rotator interval, (2) coracohumeral ligament, (3) superior capsule, (4) middle glenohumeral ligament, (5) anterior inferior glenohumeral ligament, and (6) posterior inferior glenohumeral ligament. ROMs in forward flexion (FF), lateral elevation (LE), external rotation with the arm at the side (ER1), external rotation at 90° of LE (ER2), internal rotation at 90° of LE (IR2), horizontal flexion, external rotation at 90° of FF (ER3), and internal rotation at 90° of FF (IR3) were evaluated before and after each release. Results: A total of 32 consecutive shoulders were included. After each capsular release, the ROM recovered; the final ROM was significantly greater on the affected side than on the unaffected side. Significant correlations were found between FF and LE, FF and ER1, ER1 and ER2, ER1 and ER3, ER2 and ER3, and IR2 and IR3 on both sides, regardless of surgery. Conclusion: Each segment of the joint capsule affected ROM in all directions, supporting the need for whole-joint capsular release; ROM was significantly greater on the affected side than on the unaffected side after surgery.

Original languageEnglish
Pages (from-to)1836-1842
Number of pages7
JournalJournal of Shoulder and Elbow Surgery
Volume29
Issue number9
DOIs
Publication statusPublished - 2020 Sep

Keywords

  • Case Series
  • Frozen shoulder
  • Level IV
  • Treatment Study
  • arthroscopic capsular release
  • beach-chair position
  • coracohumeral ligament
  • goniometer
  • joint capsule
  • range of motion

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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