title: Clinical evaluation of arthroscopic treatment of shoulder adhesive capsulitis.
abstract: OBJECTIVE
  To evaluate the results of arthroscopic releases performed in patients with adhesive capsulitis refractory to conservative treatment.
  
  
  METHODS
  This was a retrospective study, conducted between 1996 and 2012, which included 56 shoulders (52 patients) that underwent surgery; 38 were female, and 28 had the dominant side affected. The mean age was 51 (29-73) years. The mean follow-up was 65 (12-168) months and the mean preoperative time was 8.9 (2-24) months. According to Zukermann's classification, 23 cases were considered primary and 33 secondary. With the patient in the lateral decubitus position, circumferential release of the joint capsule was performed: joint debridement; rotator interval opening; coracohumeral ligament release; anterior, posterior, inferior, and finally antero-inferior capsulotomy. A subscapularis tenotomy was performed when necessary. All patients underwent intense physical therapy in the immediate postoperative period. In 33 shoulders, an interscalene catheter was implanted for anesthetic infusion. Functional results were evaluated by the UCLA criteria.
  
  
  RESULTS
  Improved range of motion was observed: mean increase of 45° of elevation, 41° of external rotation and eight vertebral levels of medial rotation. According to the UCLA score excellent results were obtained in 25 (45%) patients; good, in 24 (45%); fair, in two (3%); and poor, in two (7%). Patients who had undergone inferior capsulotomy achieved better results. Only 8.8% of patients who used the anesthetic infusion catheter underwent postoperative manipulation. Seven patients had complications.
  
  
  CONCLUSIONS
  There was improvement in pain and range of motion. Inferior capsulotomy leads to better results. The use of the interscalene infusion catheter reduces the number of re-approaches.
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Departamento de Ortopedia e Traumatologia, Grupo de Cirurgia do Ombro e Cotovelo, São Paulo, SP, Brazil.
authors.forename: Alberto Naoki
authors.initials: AN
authors.lastname: Miyazaki
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Departamento de Ortopedia e Traumatologia, Grupo de Cirurgia do Ombro e Cotovelo, São Paulo, SP, Brazil.
authors.forename: Pedro Doneux
authors.initials: PD
authors.lastname: Santos
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Departamento de Ortopedia e Traumatologia, Grupo de Cirurgia do Ombro e Cotovelo, São Paulo, SP, Brazil.
authors.forename: Luciana Andrade
authors.initials: LA
authors.lastname: Silva
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Departamento de Ortopedia e Traumatologia, Grupo de Cirurgia do Ombro e Cotovelo, São Paulo, SP, Brazil.
authors.forename: Guilherme do Val
authors.initials: GD
authors.lastname: Sella
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Departamento de Ortopedia e Traumatologia, Grupo de Cirurgia do Ombro e Cotovelo, São Paulo, SP, Brazil.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Carrenho
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Departamento de Ortopedia e Traumatologia, Grupo de Cirurgia do Ombro e Cotovelo, São Paulo, SP, Brazil.
authors.forename: Sergio Luiz
authors.initials: SL
authors.lastname: Checchia
keywords: Arthroscopy; Bursitis; Shoulder pain