Arthroscopic extended rotator interval release for treating refractory adhesive capsulitis

Tsai, Ming Jr; Ho, Wan‐Ling; Chen, Chih-Hwa; Leu, Tsai Hsueh; Chuang, Tai Yuan

doi:10.1177/2309499017692717

Cited by 13 publications

(32 citation statements)

References 27 publications

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“…32 Our understanding of the RI can help us treat the shoulder during arthroscopic intervention in conditions such as adhesive capsulitis or shoulder instability. 39,44 The relatively new finding of an anatomical structure in the RI like the CGL may continue to change our knowledge about shoulder biomechanics and further clarify identification and clinical management of pathologic processes. Additional studies are needed to clarify the role of the RI and RC and its associated structures in the setting of shoulder instability to better define indications and improve surgical techniques.…”

Section: Resultsmentioning

confidence: 99%

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Rotator cable and rotator interval: anatomy, biomechanics and clinical importance

2019

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The rotator cable and rotator interval are among the most recent topics of interest in current shoulder literature. Most of the research has been published in the last two decades and our understanding about the importance of these anatomical structures has improved with biomechanical studies, which changed the pre- and intra-operative approaches of shoulder surgeons to rotator cuff tears in symptomatic patients. The rotator cable is a thick fibrous bundle that carries the applied forces to the rotator cuff like a ‘suspension bridge’. Tears including this weight-bearing bridge result in more symptoms. On the other hand, the rotator interval is more like a protective cover consisting of multiple layers of ligaments and the capsule rather than a single anatomical formation like the rotator cable. Advances in our knowledge about the rotator interval demonstrate that even basic anatomical structures often have greater importance than we may have understood. Misdiagnosis of these two important structures may lead to persistent symptoms. Furthermore, some distinct rotator cuff tear patterns can be associated with concomitant rotator interval injuries because of the anatomical proximity of these two anatomical regions. We summarize these two important structures from the aspect of anatomy, biomechanics, radiology and clinical importance in a review of the literature. Cite this article: EFORT Open Rev 2019;4:56-62. DOI: 10.1302/2058-5241.4.170071.

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Section: Resultsmentioning

confidence: 99%

“…They declared that the technique does not increase the risk of instability and avoids injury of the axillary nerve and fluid extravasation. 39…”

Section: Biomechanical and Clinical Importance Of The Rotator Cable Amentioning

confidence: 99%

Rotator cable and rotator interval: anatomy, biomechanics and clinical importance

2019

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“…There were 2 studies (2 LD position) 3,4 that performed ACR by release of only the rotator cuff interval and the contracted coracohumeral ligament, 1 study (1 BC position) 28 by release of the superior edge of the subscapularis, 12 studies (8 BC position, 8,16,17,33,36,42,43,45 4 LD position 5,22,30,41 ) by release of the anterior capsule, 11 studies (6 BC position, 8,16,17,28,33,40 5 LD position 3–5,22,30 ) by release of the posterior capsule, 1 study (1 LD position 6 ) by 270° capsulectomy, and 12 studies (4 BC position, 2,25,26,35 8 LD position 7,12–14,18,19,32,34 ) by 360° capsulectomy.…”

Section: Resultsmentioning

confidence: 99%

“…This was then followed by gentle manipulation of the shoulder joint in 22 studies (12 BC position, ¶ 10 LD position 3–7,14,22,32,34,41 ). Additionally, 7 studies (2 BC position, 8,25 5 LD position 12,13,19,30,39 ) clearly stated that no concomitant manipulation was performed, while 1 LD study 30 did not clearly state whether concomitant manipulation was performed.…”

Section: Resultsmentioning

confidence: 99%

Outcomes of Arthroscopic Capsular Release in the Beach-Chair Versus Lateral Decubitus Position: A Systematic Review

Houck

Belk

Vidal

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background:Arthroscopic capsular release (ACR) for the treatment of adhesive capsulitis of the shoulder can be performed in either the beach-chair (BC) or lateral decubitus (LD) position.Purpose:To determine the clinical outcomes and recurrence rates after ACR in the BC versus LD position.Study Design:Systematic review; Level of evidence, 4.Methods:A systematic review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed by searching PubMed, Embase, and the Cochrane Library databases for studies reporting clinical outcomes of patients undergoing ACR in either the BC or LD position. All English-language literature from 1990 through 2017 reporting on clinical outcomes after ACR with a minimum 3-month follow-up were reviewed by 2 independent reviewers. Recurrence rates, range of motion (ROM) results, and patient-reported outcome (PRO) scores were collected. Study methodological quality was evaluated using the modified Coleman Methodology Score (MCMS).Results:A total of 30 studies (3 level 1 evidence, 2 level 2 evidence, 4 level 3 evidence, 21 level 4 evidence) including 665 shoulders undergoing ACR in the BC position (38.1% male; mean age, 52.0 ± 3.9 years; mean follow-up, 35.4 ± 18.4 months) and 603 shoulders in the LD position (41.8% male; mean age, 53.0 ± 2.3 years; mean follow-up, 37.2 ± 16.8 months) were included. There were no significant differences in overall mean recurrence rates between groups (BC, 2.5%; LD, 2.4%; P = .81) or in any PRO scores between groups (P > .05). There were no significant differences in improvement in ROM between groups, including external rotation at the side (BC, 36.4°; LD, 42.8°; P = .91), forward flexion (BC, 64.4°; LD, 79.3°; P = .73), abduction (BC, 77.8°; LD, 81.5°; P = .82), or internal rotation in 90° of abduction (BC, 40.8°; LD, 45.5°; P = .70). Significantly more patients in the BC group (91.6%) underwent concomitant manipulation than in the LD group (63%) (P < .0001). There were significantly more patients with diabetes in the LD group (22.4%) versus the BC group (9.6%) (P < .0001).Conclusion:Low rates of recurrent shoulder stiffness and excellent improvements in ROM can be achieved after ACR in either the LD or BC position. Concomitant manipulation under anesthesia is performed more frequently in the BC position compared with the LD position.

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“…The lack of sufficient gliding between the 2 tendons and the capsule can be restored after prompt hydrodissection using this approach. 11…”

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confidence: 99%

Ultrasound‐Guided Hydrodilatation of the Shoulder Capsule at the Rotator Interval: Technical Tips and Tricks

2020

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Adhesive capsulitis and disorders of the intra‐articular portion of the long head of the biceps brachii tendon are common causes of shoulder pain. Sonographic findings, coupled with clinical evaluation and medical history, are paramount for prompt diagnosis. Herewith, either to precisely confirm the pain generator(s) or to appropriately treat relevant cases, ultrasound‐guided interventions are often required in daily clinical practice. Targeting the anatomical structures involved in the aforementioned pathological conditions, we briefly describe some technical tips and tricks as regards ultrasound‐guided hydrodilatation of the shoulder capsule at the rotator interval.

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Arthroscopic extended rotator interval release for treating refractory adhesive capsulitis

Cited by 13 publications

References 27 publications

Rotator cable and rotator interval: anatomy, biomechanics and clinical importance

Rotator cable and rotator interval: anatomy, biomechanics and clinical importance

Outcomes of Arthroscopic Capsular Release in the Beach-Chair Versus Lateral Decubitus Position: A Systematic Review

Ultrasound‐Guided Hydrodilatation of the Shoulder Capsule at the Rotator Interval: Technical Tips and Tricks

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