A prospective study to evaluate factors associated with clinical and functional outcome of arthroscopic capsular release for primary adhesive capsulitis of the shoulder

Abstract

Objectives: A prospective study to evaluate factors associated with the clinical and functional impact of arthroscopic capsular release (ACR) for primary adhesive capsulitis of the shoulder. Materials and Methods: This prospective observation study included 34 patients diagnosed with primary adhesive capsulitis who underwent ACR after failing at least 2 months of conservative management. The patients who were willing and eligible for the study were assessed preoperatively and postoperatively. Each patient’s participation in the study will be for a maximum of 12 weeks post-operative, with follow-up at 2, 4, and 12 weeks. At each follow-up, pain was assessed by Visual Analog Scale (VAS), range of motion (ROM), and functional impact was assessed by Constant–Murley score (CMS). Values were recorded using a Microsoft Excel spreadsheet, analyzed by Chi-square, analysis of variance, and paired t -test. Results: Post-operative assessments demonstrated a statistically significant improvement in both pain and function. The mean VAS score improved from 7.79 preoperatively to 1.47 at final follow-up. The CMS showed marked improvement, with mean scores increasing from 34.8 to 75.09. Diabetic patients showed relatively delayed recovery and slightly lower functional scores, although final outcomes remained favorable. Early surgical intervention was associated with better post-operative ROM and faster functional recovery. Conclusion: ACR is a safe and effective treatment modality for primary adhesive capsulitis, leading to significant pain relief and functional improvement. Patient-specific prognostic factors aid in counseling for surgical intervention, resulting in optimization of surgical timing and expectations. Early surgical intervention and non-diabetic status were associated with superior outcomes.