| Arthroscopic Global Capsular Release in the Refractory Frozen Shoulder |
| Yong-Girl Rhee, M.D., Chang-Moo Yim, M.D., Seong-Bum Bae, M.D*. |
| Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
Department of Orthopaedic Surgery, Pusan Seil General Hospital, Pusan, Korea* |
| 불응성 동결견에 대한 관절경하 관절낭 유리술 |
| 이용걸, 임창무, 배성범 |
| 경희대학교 의과대학 정형외과학교실 |
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| Abstract |
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Forty two patients who had been treated arthroscopically for idiopathic frozen shoulder were evaluated subjectively and objectively at 15 months to 38 months for follow up(average; 26 months). Most of these patients had severe pain, especially aggravated night pain and markedly restricted humeroscapular motion. The preoperative range of motion averaged 95 degrees of forward elevation, 17 degrees of extemal rotation, and intemal rotation to the level of the fifth lumbar spinous process. In the arthroscopic finding, congested synovitis, especially at anterosuperior capsule existed in all. Synovitis of the biceps tendon was found in 36%, subscapular recess was obliterated in 64%, the superior glenohumeral ligament and the middle glenohumeral ligament each in 92 and 73percent was thickened, around all had thickened inferior glenohumeral ligament. We debrided these hyperemic synovial tissue and released the whole global capsule that might restrict the glenohumeral motion. Thirty two patients(76%) were completely free of pain at the last follow up, seven patients(17%) had intermittent pain only on extreme motion, but all of them could do the activities of daily living well. Three patients(7%) who were diabetics had persistent pain and unsatisfactory final results. Forward elevation was improved upto 168 degrees, extemal rotation to 55 degrees, and internal rotation to the level of the tenth thoracic spinous process. The average preoperative UCLA rating score was 42 points, while the average postarthroscopic UCLA rating score was improved upto 84 points. Therefore arthroscopic global capsular release could be recommended in the treatment of refractory frozen shoulders which failed to respond to conservative management |
| Key Words:
견관절; 동결견; 관절경하 유리술 ; Shoulder; Frozen shoulder; Arthroscopic release |
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