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Clinical evaluation of arthroscopic treatment of shoulder adhesive capsulitis a??

机译:关节镜下治疗肩周炎性肩周炎的临床评价

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OBJECTIVE: To evaluate the results of arthroscopic releases performed in patients with adhesive capsulitis refractory to conservative treatment. METHODS: This was a retrospective study, conducted between 1996 and 2012, which included 56 shoulders (52 patients) that underwent surgery; 38 were female, and 28 had the dominant side affected. The mean age was 51 (29-73) years. The mean follow-up was 65 (12-168) months and the mean preoperative time was 8.9 (2-24) months. According to Zukermann's classification, 23 cases were considered primary and 33 secondary. With the patient in the lateral decubitus position, circumferential release of the joint capsule was performed: joint debridement; rotator interval opening; coracohumeral ligament release; anterior, posterior, inferior, and finally antero-inferior capsulotomy. A subscapularis tenotomy was performed when necessary. All patients underwent intense physical therapy in the immediate postoperative period. In 33 shoulders, an interscalene catheter was implanted for anesthetic infusion. Functional results were evaluated by the UCLA criteria. RESULTS: Improved range of motion was observed: mean increase of 45?° of elevation, 41?° of external rotation and eight vertebral levels of medial rotation. According to the UCLA score excellent results were obtained in 25 (45%) patients; good, in 24 (45%); fair, in two (3%); and poor, in two (7%). Patients who had undergone inferior capsulotomy achieved better results. Only 8.8% of patients who used the anesthetic infusion catheter underwent postoperative manipulation. Seven patients had complications. CONCLUSION: There was improvement in pain and range of motion. Inferior capsulotomy leads to better results. The use of the interscalene infusion catheter reduces the number of re-approaches.
机译:目的:评估保守治疗难以治疗的粘膜囊炎患者的关节镜检查结果。方法:这是一项回顾性研究,于1996年至2012年期间进行,其中包括56例肩膀(52例)接受了手术治疗。 38名女性,其中28名患侧受累。平均年龄为51(29-73)岁。平均随访时间为65(12-168)个月,平均术前时间为8.9(2-24)个月。根据Zukermann的分类,其中23例被认为是原发,33例是继发性。患者处于侧卧位时,进行关节囊的周向释放。转子间隔开胸腔韧带释放;前,后,下,最后,前-下囊切开术。必要时进行肩s下腱切术。术后即刻,所有患者均接受了强烈的物理治疗。在33个肩部植入了肌间沟导管以进行麻醉输注。通过UCLA标准评估功能结果。结果:观察到运动范围得到改善:仰角平均增加45°,外旋增加41°,椎体旋转增加8个椎骨水平。根据UCLA评分,有25位(45%)患者获得了极好的结果;好,为24(45%);公平,一分为二(3%);和穷人,有两个(7%)。接受下囊切开术的患者获得了更好的结果。术后使用麻醉输液导管的患者只有8.8%。七例有并发症。结论:疼痛和运动范围有所改善。下囊切开术导致更好的结果。肌间沟输注导管的使用减少了重新治疗的次数。

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