JSES Rev Rep Tech. 2025 Aug 18;5(4):730-737. doi: 10.1016/j.xrrt.2025.07.026. eCollection 2025 Nov.
ABSTRACT
BACKGROUND: Frozen shoulder (FS) is an inflammatory condition that affects the shoulder capsule and can cause significant pain and stiffness. The arthroscopic FS 360° release is indicated in patients with global active range of motion (AROM) limitation. The aim of this study is to determine whether various patient demographic and pathological variables influence patient-reported outcome measures (PROMs) following a complete capsule resection. The variables of interest include patient comorbidity status, conservative therapy prior to surgery, and time from symptom onset to surgical treatment.
METHODS: An observational prospective cohort study was conducted assessing PROMs and AROM in patients undergoing the 360° arthroscopic release between July 2013 and January 2019. AROM and PROMs including the Oxford Shoulder Score; Western Ontario Shoulder Index; Disabilities of the Arm, Shoulder and Hand; Constant-Murley Score, American Shoulder and Elbow Surgeons score, as well as general measures of pain intensity (visual analog scale) and wellbeing (Euro Quality of Life Measure) were collected preoperatively, 2 weeks, 6 weeks, 3 months, 6 months, 12 months, and 24 months postoperatively. Patient demographic variables including comorbidity status (diabetes mellitus, thyroid disorders), preoperative therapy (physiotherapy, cortisone injections), and symptomatic timeframe prior to surgical treatment were also collected.
RESULTS: Fifty consented patients underwent the arthroscopic FS 360° release. The mean age was 52.1 ± 7.7 years (range 35-72), and mean body mass index was 27.1 ± 4.7 kg/m2 (range 19.5-37.5). There were no significant differences across all AROM and PROMs between patients with and without diabetes mellitus and thyroid disorders at 24 months postoperatively (all P > .05). There were no significant differences across all AROM and PROMs between patients that had undergone prior conservative therapy and those that had not at 24 months postoperatively (all P > .05). Finally, there was no statistical relationship found between symptomatic timeframe prior to surgery, and AROM and most PROMs at 24 months postoperatively (all P > .05). However, those with a shorter symptomatic timeframe (0-3 months) displayed a significantly better American Shoulder and Elbow Surgeons score compared to those with longer symptomatic timeframes at 24 months postop (P = .045). No complications or reoperations were reported.
CONCLUSION: The arthroscopic 360° shoulder capsule release is a safe procedure with demonstrated improvements across all PROMs and AROM movements. Patient comorbidity status, prior conservative therapy, and symptomatic timeframe did not influence functional and symptomatic postoperative outcomes 24 months after surgery.
PMID:41179460 | PMC:PMC12573591 | DOI:10.1016/j.xrrt.2025.07.026