Adhesive capsulitis of the hip: a review addressing diagnosis, treatment and outcomes

Abstract

Adhesive capsulitis (AC) of the hip (i.e. ‘Frozen Hip’), in part due to its difficulty in diagnosis, is an often overlooked and underappreciated entity of hip morbidity. This review aimed to elucidate a diagnostic approach and the surgical treatment options (with associated outcomes) of employing hip arthroscopy in the setting of AC. Electronic databases (EMBASE, MEDLINE and PubMed) were searched for available sources for all relevant clinical studies addressing the surgical management of AC. Additionally, reference lists of studies were hand-searched to find all relevant articles. Articles were systematically screened in duplicate, with agreement and descriptive statistics presented. Ten studies satisfied inclusion criteria. A total of 40 patients (mean age of 47.1 ± 14.8 years) were included. Diagnosis of AC of the hip commonly encompassed a combination of: decreased joint capacity; hip pain exacerbated by weight bearing or activity; and progressive decrease in global range of motion. Diagnostic arthroscopy was utilized in nine patients, and successful diagnosis of AC was achieved in all nine patients. Common treatments included pressure dilation (11 cases) and manipulation under anesthesia (11 cases). AC continues to be a difficult clinical entity to diagnose. Similarities are seen between hip AC and shoulder AC as diagnosis is often a result of ruling out all other possible conditions, and treatment options and outcomes resemble those of the shoulder counterpart. With successful outcomes harping on timely diagnosis and effective treatment, the use of hip arthroscopy may be of benefit to achieving this.

Adhesive capsulitis of the hip joint in a young female. A case-report

“…ACH is a poorly understood condition that can occur without any concomitant pathology [ 2 ].The natural history of the disease starts with inflammatory synovitis and ends with chronic fibrosis [ 3 , 9 ]. Exclusion of other hip pathologies essential, MRA can be used if ACH is suspected; Joo YD et al reported capsular thickening in most of patients with the diagnosis of ACH, especially the superior, and the posterior recess [ 4 ].…”

“…It was first reported by Caroit et al [ 1 ]. This condition is commonly affecting young women and may be primary (idiopathic), or secondary to hip surgery, hip infection, or repetitive microtrauma [ [2] , [3] , [4] , [5] ].…”

“…It might be self-limiting with spontaneous resolution within 3–18 months. However sometimes it takes longer time [ 1 , 3 , 7 , 8 ].…”

“…Limitation of active and passive range of motion is a recognized feature in physical examination [ 2 , 6 ]. Laboratory tests and standard image are essential to rule out other diseases [ 3 ]. Capsular thickening, especially in the superior and posterior recess of the joint's capsule, might be associated with ACH [ 4 ].…”

Refractory pain following hip arthroscopy: evaluation and management

“…Failed hip arthroscopy may be defined as persistent postoperative pain and/or stiffness—diagnosed by a combination of decreased joint capacity and global range of motion (ROM)—that does not improve with nonsurgical means [ 5 ]. In a systematic review of 6134 patients, Harris et al [ 6 ] reported a reoperation rate of 6.3% after index hip arthroscopy.…”