Surgical results of one-stage arthroscopic repair of rotator cuff tears with adhesive capsulitis using anterior or global capsular release

Abstract

The purpose of the study is to compare the clinical outcomes and recovery pattern of anterior capsular release and global capsular release for one-stage arthroscopic repair of rotator cuff tears with adhesive capsulitis. Among patients who underwent arthroscopic rotator cuff repairs with a concomitant adhesive capsulitis, 46 patients were treated with either anterior capsular release (group A ; n = 24) or global capsular release (group B ; n = 22). Preoperative mean passive forward flexion was 109º in group A and 107º in group B, whereas external rotation at the side was 27º and 29º, respectively. All patients were evaluated at a minimum 2-year follow- up in terms of visual analog scale for pain, muscle power, range of motion, Constant score, subjective shoulder value, modified American Shoulder and Elbow Surgeons (ASES) shoulder evaluation form, and modified University of California at Los Angeles (UCLA) scores. The mean modified ASES score was 89.3 for group A and 88.9 for group B (P = .780). The mean UCLA scores were 34.8 and 33.9, respectively (P = .570). The 2 groups showed no significant difference in forward flexion and external rotation postoperatively, as group B recovered more slowly in external rotation. The group A showed a better visual analog scale for pain postoperatively. The global capsular release did not produce better clinical outcomes than anterior capsular release. Overall satisfactory results can be achieved either by anterior capsular release or by global release in a one-stage arthroscopic surgery for rotator cuff tear and adhesive capsulitis. This arthroscopic rotator cuff repair with anterior capsular release might be a reasonable alternative treatment for patients with rotator cuff tear with adhesive capsulitis.

Level of Evidence : Level III, retrospective com-parative study.