Arthroscopic Release and Manipulation for Frozen Shoulder
徐郭堯(Kuo-Yao Hsu)；陳永仁(Yeung-Jen Chen)；廖宜賢(Yi-Shyan Liao)；何為斌(Wei-Pin Ho)；施信農(Hsin-Nung Shih)；程俊穎(Chun-Ying Cheng)；黃聰仁(Tsung-Jen Huang)；許文蔚(Wen-Wei Hsu)
Arthroscopic release ； Frozen shoulder
Journal of Orthopaedic Surgery Taiwan
|Volume or Term/Year and Month of Publication||
13卷1期（1996 / 03 / 01）
25 - 29
Nighteen patients with a diagnosis of frozen shoulders treated with a combination of arthroscopic release and manual manipulation were reported. All had been treated with physical therapy for months and anti-inflammatory drugs without improvement and werre referred to the shoulder clinic for possible further management. There were eleven men and eight women, age ranged from 40 to 70. The nondominant arms were affected in 10 out of 19 patients, and bilateral involvement were not found in this group. All patients had pain and restricted motions in all planes, and pain is exacerbated approaching the extreme limits of motion. Under general anesthesia, the patients were placed in the beach chair position. The arthroscopic examination was first performed. The arthroscopic findings included anterior synovitis around the biceps tendon, anterior capsule and axillary pouch. A synovial resector was then introduced from the anterior portal to excise the synovium. The adhesions usually located over the subscapular bursa and rotator interval. While viewing the anterior capsule and releasing the adhesions, we manipulated the arm into extreme external rotation position. If the release is adequate, the smooth rolling movement of subscapularis tendon could be clearly identified during the external rotation movement immediately. Postoperatively, majority of the patients felt the joints were loosended up. The physiotherapy were immediately initiated. Pain relief was achieved by every patient with an average 80% improvement by using visual analog scale. The forward elevation increased from an average of 95∘to 170∘ postoperatively. The external rotation at side increased from an average of 5∘to 45∘ postoperatively. The improvement in internal rotation is not so significant, with an average increase of 5 vertebral heights. There were no complications in this series. The subjective satisfaction of patients is excellent. We concluded that arthroscopic release is a safe and effective modality in the treatment of frozen shoulder. It is a valuable adjunct to other conservative measures when nonoperative treatment fails to improve the symptoms.