A study comparing the efficacy of a combination of arthroscopic capsular release with sub acromial decompression, rotator interval release along with manipulation under general anesthesia and only manipulation under general anesthesia in the treatment of shoulder primary adhesive capsulitis

Introduction: Adhesive capsulitis is one of the shoulder’s most common benign disorders. Its etiology varies from post-traumatic, association with diabetes and hypothyroidism to idiopathic. According to many research studies it is a self-limiting condition, according to its natural history it takes around 9 months to 2 years to resolve. Patient has to suffer the morbidity until then. To hasten the resolving process many treatment methods have been proposed ranging from non-invasive types like physiotherapy and manipulation under GA to minimally invasive types like local infiltration of steroid, platelet rich plasma, hyaluronic acid and arthroscopic capsular release. In this study a comparison has been made between the efficacy of combination of arthroscopic capsular release with sub acromial decompression, rotator interval release plus MUGA and only MUGA. The results obtained in the study are also discussed and compared with the existing literature. Materials and Methods: An prospective interventional study of 40 patients aged between 30 to 60 years suffering from primary adhesive capsulitis refractory to treatment with physiotherapy [Dr. Brian Dierckman protocol] and analgesics for a period of 6 months, hence treated with combination of arthroscopic adhesiolysis with sub acromial decompression, rotator interval release plus MUGA and only MUGA was done. Patients have been randomly allocated into 2 groups (20 patients in each group) by simple random sampling using chits. The outcome of the patients in each group has been observed and followed up to a period of 6 months. Result: Statistically there is a significant difference between the outcomes of only MUGA and combination of arthroscopic adhesiolysis with sub acromial decompression, rotator interval release and MUGA. Arthroscopic adhesiolysis with sub acromial decompression, rotator interval release and MUGA shows superior results in both the Oxford shoulder score and visual analogue scale from 1 month follow up