AJSM Click here for details!
HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Sign In to gain access to subscriptions and/or personal tools.
First published on February 13, 2008, doi:10.1177/0363546507313090
This version was published on May 1, 2008
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
36/5/921    most recent
0363546507313090v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Google Scholar
Right arrow Articles by Liem, D.
Right arrow Articles by Poetzl, W.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Liem, D.
Right arrow Articles by Poetzl, W.
Related Collections
Right arrow Kinematics and kinetics
Right arrow Shoulder
Right arrow Arthroscopy
The American Journal of Sports Medicine 36:921-926 (2008)
© 2008 American Orthopaedic Society for Sports Medicine

The Influence of Arthroscopic Subscapularis Tendon and Capsule Release on Internal Rotation Strength in Treatment of Frozen Shoulder

Dennis Liem, MD{dagger},*, Felix Meier, MD{dagger}, Lothar Thorwesten, PhD{ddagger}, Bjoern Marquardt, MD{dagger}, Joern Steinbeck, MD§ and Wolfgang Poetzl, MD||

From the {dagger} Department of Orthopaedics and the {ddagger} Department of Sports Medicine, University Hospital of Muenster, Muenster, the § Orthopaedic Practice Clinic, Muenster, and the || Department of Shoulder and Elbow Surgery, Vulpiusklinik, Bad Rappenau, Germany

* Address correspondence to Dennis Liem, MD, Department of Orthopaedics, University Hospital of Muenster, Albert Schweizer Street 33, 48149 Muenster, Germany (e-mail: dennisliem{at}web.de).

Background: Arthroscopic release of the capsule is a popular treatment option for chronic refractory frozen shoulder. Additional release of the intra-articular part of the subscapularis is controversial regarding possible impairment of subscapularis function.

Hypothesis: Arthroscopic release of the intra-articular part of the subscapularis produces good clinical results and does not lead to reduced internal rotation strength.

Study Design: Case series; Level of evidence, 4.

Methods: Twenty-two patients were retrospectively evaluated 53 months (range, 12–106) after undergoing arthroscopic anterior capsular release, including release of the intra-articular portion of the subscapularis. Clinical outcome was evaluated using the American Shoulder and Elbow Surgeons score and the Constant score. Isometric and isokinetic strength for internal and external rotation were determined at the time of follow-up in both shoulders using a Cybex dynamometer.

Results: The Constant score was improved significantly from 17.7 points to 82.8 points (P < .0001) and the American Shoulder and Elbow Surgeons score increased significantly from 23.5 points to 76.8 points (P < .0001). The mean range of motion was significantly improved for external rotation from 16 ° to 58° , from 66 ° to 142 ° for abduction, and from 76 ° to 155 ° for forward flexion. Isometric and isokinetic strength in the standard abduction position of the Cybex dynamometer showed no significant side-to-side difference.

Conclusion: Arthroscopic capsular release combined with a release of the intra-articular portion of the subscapularis tendon revealed good clinical results in the arthroscopic treatment of adhesive capsulitis without significant loss of internal rotation strength.

Key Words: frozen shoulder • subscapularis release • capsular release • isokinetic strength






HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2008 by the American Orthopaedic Society for Sports Medicine.