title: The influence of arthroscopic subscapularis tendon and capsule release on internal rotation strength in treatment of frozen shoulder.
abstract: 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.
  
  
  OBJECTIVE
  Arthroscopic release of the intra-articular part of the subscapularis produces good clinical results and does not lead to reduced internal rotation strength.
  
  
  METHODS
  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 degrees to 58 degrees , from 66 degrees to 142 degrees for abduction, and from 76 degrees to 155 degrees for forward flexion. Isometric and isokinetic strength in the standard abduction position of the Cybex dynamometer showed no significant side-to-side difference.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopaedics, University Hospital of Muenster, Albert Schweizer Street 33, 48149 Muenster, Germany. dennisliem@web.de
authors.forename: Dennis
authors.initials: D
authors.lastname: Liem
authors.forename: Felix
authors.initials: F
authors.lastname: Meier
authors.forename: Lothar
authors.initials: L
authors.lastname: Thorwesten
authors.forename: Bjoern
authors.initials: B
authors.lastname: Marquardt
authors.forename: Joern
authors.initials: J
authors.lastname: Steinbeck
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Poetzl
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000473:pathology / Q000601:surgery*; D007592:Joint Diseases / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D013710:Tendons / Q000601:surgery*; D016896:Treatment Outcome