Arthroscopic treatment of adhesive capsulitis of the shoulder (Il trattamento artroscopico della capsulite adesiva di spalla)

Purpose of the study: To find out the prognostic factors of adhesive capsulitis of the shoulder treated by arthroscopic capsular release in a prospective study. Type of the study: Prognostic prospective study. Level of evidence: Level I. Materials and methods: We evaluated prospectively 47 patients (18 males and 29 females) affected by primary adhesive capsulitis of the shoulder. All patients underwent an arthroscopic capsular release. Mean age of the patients was 53.5 years. Dominant arm was involved in 61.7% of the cases. Time elapsed from onset of symptoms to surgery ranged between 3 and 48 months (average: 15.8 months). We found a diabetes mellitus in 42.6% of the cases and a full-thickness rotator cuff tear in 29.8% of the cases. Cuff tears were not repaired. All the patients were evaluated at follow-up, which ranged from 24 to 60 months (average: 37.5 months). Preoperative and outcome evaluation were performed with the Constant-Murley score. Absolute score, relative score (corrected for gender and age) and improvement in points were evaluated according to the following variables: gender, age, dominance, timing, diabetes mellitus, rotator cuff tear, duration of follow-up, and preoperative score. Statistical analysis was performed using t-test for dichotomic variables and linear correlation for continuous variables. Significance was considered for p<0.05. Results: Overall results were 69.5 for absolute score, 87 for relative score and 42.1 for improvement in points. We did not found a significant correlation between outcome and all the variables considered, except for preoperative score, which showed a significant correlation with follow-up score. Diabetes was weakly correlated with the outcome. Conclusion: Age, gender, dominance, timing, rotator cuff tear, and duration of follow-up had not prognostic value for the outcome of adhesive capsulitis treated by arthroscopic release. Diabetes mellitus is a weak prognostic factor. The only significant prognostic factor we found out was preoperative score.