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84 – ARTHROSCOPIC TREATMENT OF SHOULDER STIFFNESS: RESULTS ACCORDING TO ETIOLOGY IN 30 PATIENTS



Abstract

Purpose: The objective of this study was to analyze the clinical results of arthroscopic release for the treatment of shoulder stiffness and to report the results according to etiology.

Method: Thirty cases were reviewed in 29 patients with a mean age of 48 years [range, 25–75]. The mean time from diagnosis to surgery was 37.5 months [range, 6–120]. The stiffness was considered idiopathic (i.e. frozen shoulder) (10 cases), post-traumatic (eight cases) or post-surgical (12 cases). The release consisted of 14 rotator interval resections, four anterior capsulotomies, 20 anterior and inferior capsulotomies, three tenotomies of the superior portion of the subscapularis, and 11 biceps tenotomies or tenodeses. In 26 cases, associated extra-articular procedures were also performed, including 22 subacromial bursectomies and four acromioplasties. Patients were reviewed at a mean follow-up of 44 months [range, 12–99].

Results: Eighty-nine percent were satisfied or very satisfied. The mean Subjective Shoulder Value was 76%. The mean Constant score increased from 40 ± 13 points preoperatively to 74 ± 16 points postoperatively (p< 0.05).

Conclusion: Arthroscopic shoulder release is effective for pain relief and improved function. The recovery of motion is better in idiopathic stiffness (i.e. frozen shoulder) than in post-traumatic and post-surgical stiffness. Resection of the rotator interval seems effective to restore external rotation and elevation.

Correspondence should be addressed to: COA, 4150 Ste. Catherine St. West Suite 360, Westmount, QC H3Z 2Y5, Canada. Email: meetings@canorth.org