Arthroscopic release of the glenohumeral joint in shoulder stiffness:: A review of 26 cases

The purpose of this multicenter retrospective study of arthroscopic release of the glenohumeral joint was to evaluate the technical feasibility, the results, and the potential correlations between results and cause of the stiffness. Twenty-six shoulders in 25 patients (19 women and six men) were re-evaluated 3 to 72 months (mean, 21 months) after arthroscopic release of the glenohumeral joint. Diagnoses were primary frozen shoulder in 13 cases, bipolar stiffness (rotator cuff tear plus capsular contraction) in 3 cases, and postinjury or postsurgery stiffness in 10 cases. Results were evaluated on passive range of motion, Constant's score, and subjective assessment. Anterior or anterior inferior capsular release was done at the anterior rim of the glenoid fossa. Posterior capsule release was not performed in this series. Then were no intraoperative complications. Mean range of motion gains were 86 degrees for forward elevation, 72 degrees for abduction, 34 degrees for external rotation, and 6 spinal processes for internal rotation. Constant's range of motion score increased from 12.9 out of 40 to 32 out of 40 points. Thirteen patients were very satisfied, 5 satisfied, 5 improved, and 3 unchanged. Range of motion gains were independent from the cause of shoulder stiffness, but global results were better in the primary frozen shoulder group in terms of pain and strength. Arthroscopic release of the glenohumeral joint is feasible and safe. For primary frozen shoulders, in case of failure of the functional treatment, arthroscopic release is a less traumatic alternative to manipulation under general anesthesia. For bipolar stiffness, arthroscopy provides the opportunity for treating concomitant lesions. For postsurgical stiffness, arthroscopic release improves range of motion. but the shoulder often remains painful.