Long-Term Outcomes After Arthroscopic Capsular Release for Idiopathic Adhesive Capsulitis
Long-Term Outcomes After Arthroscopic Capsular Release for Idiopathic Adhesive Capsulitis
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DOI：
10.2106/jbjs.j.00952
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发表时间：
2012-07-03
影响因子：
5.3
通讯作者：
Murrell, George A. C.
中科院分区：
文献类型：
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作者：
Le Lievre, Hugh M. J.;Murrell, George A. C.
背景：治疗特发性关节囊粘连炎或肩周炎的一种治疗策略是关节镜下关节囊松解术。虽然有关于特发性肩关节囊粘连松解术后的非手术治疗和良好短期结果的长期数据，但对于关节镜下关节囊松解术后五年或更长时间的结果知之甚少。 方法：由一位外科医生通过关节镜下盂肱关节周围关节囊松解术治疗的特发性肩关节囊粘连炎患者，使用患者报告的疼痛评分、使用李克特量表进行的肩部功能评分以及肩部活动范围进行评估。术前评估以及术后 1、6、12、24 和 52 周以及平均 7 年的评估。结果：平均随访 7 年（范围为 5 到 13 年），与初次就诊时的结果 (p < 0.001) 和一年后的结果相比，43 名患者（49 个肩部）在疼痛频率和严重程度、患者报告的肩部功能、僵硬和完成活动困难方面有显着改善后续评估（p < 0.01 至 p < 0.001）。肩部活动也得到改善（p < 0.001），并且与对侧肩部的活动相当。没有出现并发症。结论：接受关节镜关节囊松解术治疗的特发性肩关节囊粘连炎患者的肩部活动范围、疼痛频率和严重程度以及功能均得到了早期显着改善。这些改进在七年后得到了维持和/或增强。与非手术治疗的报告结果相反，七岁时肩部的活动范围与对侧肩部的活动范围相当。
Background: One management strategy for the treatment of idiopathic adhesive capsulitis, or frozen shoulder, is arthroscopic capsular release. While there are long-term data regarding nonoperative treatment and good short-term outcomes following a release for idiopathic adhesive capsulitis, little is known about the outcomes five years or more after arthroscopic capsular release.Methods: Patients with idiopathic adhesive capsulitis treated with a circumferential arthroscopic capsular release of the glenohumeral joint by a single surgeon were assessed with use of patient-reported pain scores, shoulder functional scores with use of a Likert scale, and shoulder range of motion at the preoperative evaluation and at one, six, twelve, twenty-four, and fifty-two weeks and a mean of seven years after surgery.Results: At a mean follow-up of seven years (range, five through thirteen years), forty-three patients (forty-nine shoulders) had significant improvement with regard to pain frequency and severity, patient-reported shoulder function, stiffness, and difficulty in completing activities compared with the findings at the initial presentation (p < 0.001) and the one-year follow-up evaluation (p < 0.01 to p < 0.001). Shoulder motion also improved (p < 0.001) and was comparable with that of the contralateral shoulder. There were no complications.Conclusions: Patients with idiopathic adhesive capsulitis treated with an arthroscopic capsular release had early significant improvements in shoulder range of motion, pain frequency and severity, and function. These improvements were maintained and/or enhanced at seven years. In contrast to results reported for nonoperative treatment, shoulder range of motion at seven years was equivalent to that in the contralateral shoulder.