Shoulder arthroscopy: part IV idiopathic frozen shoulder: arthroscopic distension, release, and debridment

ABSTRACT

Twenty three carefully selected patients with frozen shoulder with variable degrees of complaint and severity constituted the material of the present study. All failed to response to the conventional lines of conservative treatment as an initial measures, and then, arthroscopic management was undertaken followed by a well designated physical therapy program and stretching mobilization. The indication for surgery was persistent pain, stiffness, and limited function. There were 15 [65.2%] males, and 8 [34.8%] females with an average age of 49.6 years. All were right handed, and all but 2 were unilateral dominant-side presentation - for bilateral affection, arthroscopy was done in one shoulder, the one with the severe symptoms. Before operation, all the patients had shoulder pain and motion restriction for at least 6 months despite conservative treatment. At operation, synovectomy, rotator interval capsulotomy, and glenohumeral joint and subacromial space debridment and clean-up were done for all cases, additionally, selective release procedures were performed in a controlled manner according to the findings, varied from limited freeing-up to a more aggressive or a complete release of the contracted anterior capsulo-ligamentotendinous structures. The range of external rotation at the side and in abduction was examined intermittently to check improved laxity and motion arc. The functional mobility, the range of motion in the different planes, the power, and pain were assessed and recorded before and after surgery according to the Constant scoring system [9]. Functional assessment was carried out at 3 post-operative intervals during the course of follow-up; immediate postoperative, at 10 th week, and finally at 20 th week. Final re-assessment at the end of the treatment showed appreciable improvement with no significant recorded complications. On conclusion, the combination strategy; arthroscopic management with shoulder exercises can offer effective treatment for frozen shoulder