Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Apr 26, 2015; 3(2): 82-88
Published online Apr 26, 2015. doi: 10.13105/wjma.v3.i2.82
Arthroscopic capsular release and manipulation under anaesthesia for frozen shoulders: A hot topic
Tim Kraal, Lijkele Beimers
Tim Kraal, Lijkele Beimers, Department of Orthopaedic Surgery, Slotervaartziekenhuis, 1066 EC Amsterdam, The Netherlands
Author contributions: Kraal T wrote this article with support of Beimers L who helped with the design of the article structure and reviewed the manuscript several times.
Conflict-of-interest: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lijkele Beimers, MD, PhD, Department of Orthopaedic Surgery, Slotervaartziekenhuis, Louwesweg 6, 1066 EC Amsterdam, Noord-Holland, The Netherlands. lijkele.beimers@slz.nl
Telephone: +31-20-5124554 Fax: +31-20-512339
Received: October 14, 2014
Peer-review started: October 14, 2014
First decision: December 17, 2014
Revised: December 31, 2014
Accepted: January 15, 2015
Article in press: January 19, 2015
Published online: April 26, 2015
Processing time: 196 Days and 6.3 Hours
Abstract

A frozen shoulder is a common cause of shoulder pain and stiffness. The etiology and pathology of frozen shoulders is not fully understood yet. Frozen shoulder is characterized by a decrease in intra-articular volume and capsular compliance. This can lead to significant limitations in daily life. The majority of the patients can be treated conservatively, with functional recovery to be expected in two to three years. However, if conservative treatment fails, manipulation under anaesthesia and arthroscopic capsular release can both be considered as appropriate treatments. Manipulation is a traditionally well-established technique but in recent years it seems that arthroscopic capsular release has gained popularity. Manipulation is a relative time efficient and technically low-demanding procedure in which the glenohumeral joint is forced into different directions under general anaesthesia to release the capsular contracture, thereby increasing the range of motion of the joint. In arthroscopic capsular release the glenohumeral capsule can be released in a more controlled manner under direct vision. There are no prospective comparative trials available to display superiority of one procedure over the other. In addition, the optimal timing of both these interventions still has to be determined. An overview of the literature concerning this topic and a description of both procedures with its own advantages and disadvantages is provided.

Keywords: Frozen shoulder, Adhesive capsulitis, Manipulation, Arthroscopy, Capsular release, Shoulder, Shoulder stiffness

Core tip: A frozen shoulder is a common cause of shoulder pain and stiffness, which is characterized by a decrease in intra-articular volume and capsular compliance. If conservative treatment fails, manipulation under anaesthesia and arthroscopic capsular release can both be considered as appropriate treatments. An overview of the literature concerning this topic and a description of both procedures with its own advantages and disadvantages is provided.