Arthroscopic Pan-Capsular and Transverse Humeral Ligament Release with Biceps Tenodesis for Patients with Refractory Frozen Shoulder
Arthroscopic capsular release allows direct visualization and release of inflamed tissues in refractory frozen shoulder. The reticular neural network in the long head of the biceps tendon (LHBT) and nerve endings of the transverse humeral ligament (THL) might be responsible for shoulder pain. We hyp...
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| Format: | Article |
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MDPI AG
2022-11-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/12/1712 |
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| author | Chih-Hao Chiu Huan Sheu Poyu Chen Dan Berco Yi-Sheng Chan Alvin Chao-Yu Chen |
| author_facet | Chih-Hao Chiu Huan Sheu Poyu Chen Dan Berco Yi-Sheng Chan Alvin Chao-Yu Chen |
| author_sort | Chih-Hao Chiu |
| collection | DOAJ |
| description | Arthroscopic capsular release allows direct visualization and release of inflamed tissues in refractory frozen shoulder. The reticular neural network in the long head of the biceps tendon (LHBT) and nerve endings of the transverse humeral ligament (THL) might be responsible for shoulder pain. We hypothesized that patients with painful refractory frozen shoulder benefited from pan-capsular release, THL release, and LHBT tenodesis. The LHBT tenodesis decreased the possibility of LHBT instability. The balance of the shoulder joint was maintained after such extensive release. From October 2013 to June 2019, patients with painful refractory frozen shoulder were enrolled consecutively at the same institute. All patients received arthroscopic pan-capsular, THL release, and suprapectoral LHBT tenodesis with a minimum of 2-year follow-up. Preoperative and postoperative shoulder range of motion (ROM), pain visual analog scale (PVAS), subjective shoulder value (SSV), constant score, LHBT score, acromio-humeral distance (AHD), and critical shoulder angle (CSA) were recorded. In total, 35 patients with an average age of 53.1 ± 9 years were enrolled. The average follow-up period was 24 ± 1.5 months. Forward elevation improved from 105.1° ± 17° to 147° ± 12° (<i>p</i> < 0.001), external rotation improved from 24.1° ± 13.3° to 50.9° ± 9.7° (<i>p</i> < 0.001), and internal rotation improved from L3 to T9 (<i>p</i> < 0.001), respectively, at final follow-up. PVAS improved from 7.3 ± 1.1 to 1.8 ± 0.6 (<i>p</i> < 0.001), constant score from 23.4 ± 11 to 80.7 ± 5.2 (<i>p</i> < 0.001), and SSV from 27.7 ± 10.5 to 77.4 ± 3.8, respectively, at follow-up. No differences were found in AHD and CSA after surgery (<i>p</i> = 0.316, and <i>p</i> = 0.895, respectively). Patients with painful refractory frozen shoulder benefited from pan-capsular and THL release. A radiographically balanced shoulder joint was maintained even after such extensive release. |
| first_indexed | 2024-03-09T16:08:32Z |
| format | Article |
| id | doaj.art-e109baf55a2846e6a9bf601041e4ec12 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T16:08:32Z |
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| spelling | doaj.art-e109baf55a2846e6a9bf601041e4ec122023-11-24T16:31:21ZengMDPI AGMedicina1010-660X1648-91442022-11-015812171210.3390/medicina58121712Arthroscopic Pan-Capsular and Transverse Humeral Ligament Release with Biceps Tenodesis for Patients with Refractory Frozen ShoulderChih-Hao Chiu0Huan Sheu1Poyu Chen2Dan Berco3Yi-Sheng Chan4Alvin Chao-Yu Chen5Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, TaiwanBone and Joint Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDepartment of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDepartment of Electronics Engineering and Program in Nano-Electronic Engineering and Design, Chang Gung University, Taoyuan 333, TaiwanBone and Joint Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDepartment of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, TaiwanArthroscopic capsular release allows direct visualization and release of inflamed tissues in refractory frozen shoulder. The reticular neural network in the long head of the biceps tendon (LHBT) and nerve endings of the transverse humeral ligament (THL) might be responsible for shoulder pain. We hypothesized that patients with painful refractory frozen shoulder benefited from pan-capsular release, THL release, and LHBT tenodesis. The LHBT tenodesis decreased the possibility of LHBT instability. The balance of the shoulder joint was maintained after such extensive release. From October 2013 to June 2019, patients with painful refractory frozen shoulder were enrolled consecutively at the same institute. All patients received arthroscopic pan-capsular, THL release, and suprapectoral LHBT tenodesis with a minimum of 2-year follow-up. Preoperative and postoperative shoulder range of motion (ROM), pain visual analog scale (PVAS), subjective shoulder value (SSV), constant score, LHBT score, acromio-humeral distance (AHD), and critical shoulder angle (CSA) were recorded. In total, 35 patients with an average age of 53.1 ± 9 years were enrolled. The average follow-up period was 24 ± 1.5 months. Forward elevation improved from 105.1° ± 17° to 147° ± 12° (<i>p</i> < 0.001), external rotation improved from 24.1° ± 13.3° to 50.9° ± 9.7° (<i>p</i> < 0.001), and internal rotation improved from L3 to T9 (<i>p</i> < 0.001), respectively, at final follow-up. PVAS improved from 7.3 ± 1.1 to 1.8 ± 0.6 (<i>p</i> < 0.001), constant score from 23.4 ± 11 to 80.7 ± 5.2 (<i>p</i> < 0.001), and SSV from 27.7 ± 10.5 to 77.4 ± 3.8, respectively, at follow-up. No differences were found in AHD and CSA after surgery (<i>p</i> = 0.316, and <i>p</i> = 0.895, respectively). Patients with painful refractory frozen shoulder benefited from pan-capsular and THL release. A radiographically balanced shoulder joint was maintained even after such extensive release.https://www.mdpi.com/1648-9144/58/12/1712refractory frozen shouldercapsular releasetransverse humeral ligamentbiceps tenodesis |
| spellingShingle | Chih-Hao Chiu Huan Sheu Poyu Chen Dan Berco Yi-Sheng Chan Alvin Chao-Yu Chen Arthroscopic Pan-Capsular and Transverse Humeral Ligament Release with Biceps Tenodesis for Patients with Refractory Frozen Shoulder Medicina refractory frozen shoulder capsular release transverse humeral ligament biceps tenodesis |
| title | Arthroscopic Pan-Capsular and Transverse Humeral Ligament Release with Biceps Tenodesis for Patients with Refractory Frozen Shoulder |
| title_full | Arthroscopic Pan-Capsular and Transverse Humeral Ligament Release with Biceps Tenodesis for Patients with Refractory Frozen Shoulder |
| title_fullStr | Arthroscopic Pan-Capsular and Transverse Humeral Ligament Release with Biceps Tenodesis for Patients with Refractory Frozen Shoulder |
| title_full_unstemmed | Arthroscopic Pan-Capsular and Transverse Humeral Ligament Release with Biceps Tenodesis for Patients with Refractory Frozen Shoulder |
| title_short | Arthroscopic Pan-Capsular and Transverse Humeral Ligament Release with Biceps Tenodesis for Patients with Refractory Frozen Shoulder |
| title_sort | arthroscopic pan capsular and transverse humeral ligament release with biceps tenodesis for patients with refractory frozen shoulder |
| topic | refractory frozen shoulder capsular release transverse humeral ligament biceps tenodesis |
| url | https://www.mdpi.com/1648-9144/58/12/1712 |
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