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A Randomized Comparative Study of a Standard Anterior Capsular Release versus Inferior Extended Release for the Treatment of Shoulder Stiffness
Clinics in Shoulder and Elbow 2017;20:117-125
Published online September 30, 2017
© 2017 Korean Shoulder and Elbow Society.

Ahmed Abdullah Alzeyadi, Yang-Soo Kim, Hyo-Jin Lee, Sung-Ryeoll Park, Gwang Young Sung, Dong-Jin Kim, Ji-Hwan Jung, Jong-Ho Kim

Department of Orthopedic Surgery, Seoul St. Mary셲 Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Correspondence to: Jong-Ho Kim
Department of Orthopedic Surgery, Seoul St. Mary셲 Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea
Tel: +82-2-2258-6359, Fax: +82-2-535-9834, E-mail: katris@naver.com
Received December 26, 2016; Revised June 30, 2017; Accepted July 3, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background: To compare the clinical outcomes of arthroscopic capsular release in patients with and without inferior capsular release for shoulder stiffness.
Methods: Between January 2010 and December 2015, 39 patients who underwent arthroscopic capsular release for shoulder stiffness were enrolled and randomized into two groups. In group I, 19 patients underwent arthroscopic capsular release of the rotator interval and anterior capsule. In group II, 20 patients underwent arthroscopic capsular release of the anterior to inferior capsule, including the rotator interval. The American Shoulder and Elbow Surgeons score, Constant scoring system, Simple Shoulder Test, visual analogue scale for pain, and range of motion (ROM) were used for evaluation before surgery, at 3, 6, and 12 months after surgery and on the last follow-up.
Results: Preoperative demographic data revealed no significant differences (p>0.05). The average follow-up was 16.07 months. Both groups showed significantly increased ROM at the last follow-up compared with preoperative (p<0.05). At the last follow-up, no statistical differences were found (p>0.05) between groups I and II in functional scores and ROM (forward flexion, p=0.91; side external rotation, p=0.17; abduction external rotation, p=0.72; internal rotation, p=0.61). But we found that group II gained more flexion compared to group I at 3 months and 6 months (p<0.05) after the surgery.
Conclusions: Both techniques of capsular release are effective for stiffness shoulder. However, the extended inferior capsular release shows superiority in forward flexion over anterior capsular release alone during 6 months of follows-up (level of evidence: Level I, therapeutic randomized controlled trial).
Keywords : Shoulder; Stiffness; Frozen shoulder; Arthroscopic capsular release