Resumo ObjetivoAvaliar os resultados das libera??es artroscópicas feitas em pacientes com capsulite adesiva refratária ao tratamento conservador.MétodosTrabalho retrospectivo feito entre 1996 e 2012, com 56 ombros (52 pacientes) submetidos a cirurgia; 38 eram do sexo feminino e 28 tinham o lado dominante acometido. A média de idade foi de 51 (29‐73) anos. O seguimento médio, de 65 (12‐168) meses e o tempo médio de pré‐operatório, de 8,9 (2‐24) meses. Pela classifica??o de Zukermann, 23 casos foram considerados primários e 33 secundários. Com o paciente em decúbito lateral, fizemos a libera??o circunferencial da cápsula articular: desbridamento articular, abertura do intervalo rotador, libera??o do ligamento coracoumeral, capsulotomia anterior, posterior, inferior e finalmente, anteroinferior. A tenotomia do subescapular foi feita quando necessária. Todos foram submetidos a fisioterapia intensa no pós‐operatório imediato. Em 33 ombros foi implantado o catéter interescalênico para infus?o de anestésico. Os resultados funcionais foram avaliados pelos critérios do escore da University of California at Los Angeles (UCLA).ResultadosObtivemos melhoria do arco de movimento: aumento médio de 45° de eleva??o, 41° de rota??o lateral e oito níveis vertebrais de rota??o medial. Pelo escore da UCLA, tivemos 25 resultados excelentes (45%), 25 bons (45%), dois razoáveis (3%) e quatro ruins (7%). Os pacientes que fizeram capsulotomia inferior evoluíram melhor do que os que n?o fizeram. Apenas 8,8% dos pacientes que usaram cateter de infus?o anestésico foram submetidos a manipula??o no pós‐operatório. Sete pacientes apresentaram complica??es.Conclus?oHouve melhoria da dor e do arco de movimento. A capsulotomia inferior leva a melhores resultados. O uso do catéter interescalênico de infus?o anestésica diminui o número de reabordagens. ObjectiveTo evaluate the results of arthroscopic releases performed in patients with adhesive capsulitis refractory to conservative treatment.MethodsThis 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.ResultsImproved 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 four (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.ConclusionThere 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.
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