A prospective study on functional analysis and outcome of frozen shoulder following arthroscopic capsular release in resistant cases

Abstract

Background: Frozen shoulder or adhesive capsulitis, is characterized by pain and restricted shoulder motion, significantly impairing daily function. Assessment of functional outcomes after arthroscopic capsular release is essential to evaluate treatment efficacy and guide rehabilitation Methods: This prospective observational study evaluated the efficacy of arthroscopic capsular release in 32 patients aged 45–60 years with refractory frozen shoulder. Patients with rotator cuff injuries or intra-articular fractures were excluded. Preoperative and postoperative assessments at 1, 3 and 6 months included range of motion (ROM), pain via Visual Analogue Scale (VAS), functional outcomes using Constant–Murley and ASES scores and quality of life measured by EQ-5D. Results: This study demonstrated significant improvements in shoulder ROM across all planes at 6 months (abduction: 65.2° to 140.3°, flexion: 70.4° to 145.8°, p<0.001). VAS scores decreased markedly from 7.8 to 1.0 (p<0.001). Functional scores improved substantially: Constant–Murley from 28.5 to 85.4, ASES from 32.7 to 88.2 and EQ-5D index from 0.45 to 0.91 (all p<0.001). Patients with primary etiology showed better functional recovery than secondary cases (Constant–Murley 88.2 vs. 79.4, p=0.003). Complications were minimal and transient. Conclusions: Arthroscopic capsular release is a safe and effective intervention for frozen shoulder unresponsive to conservative treatment, resulting in significant pain relief, improved shoulder function and enhanced quality of life. Primary adhesive capsulitis patients experience superior outcomes. Further research with extended follow-up is warranted to optimize rehabilitation protocols.