A Study Comparing Shoulder Primary Adhesive Capsulitis Treatment with Arthroscopic Capsular Release, Subacromial Decompression, Rotator Interval Release and Manipulation Under General Anesthesia

Abstract

Background: Primary adhesive capsulitis is a painful and disabling condition of the shoulder characterized by progressive restriction of both
active and passive movements. Common operative options include manipulation under general anesthesia and arthroscopic capsular release,
often combined with subacromial decompression and rotator interval release.
Aim: To compare the clinical and functional outcomes of arthroscopic capsular release with subacromial decompression, rotator interval release
and manipulation under general anesthesia versus manipulation under general anesthesia alone in patients with primary adhesive capsulitis.
Methodology: This prospective comparative study included 40 adult patients with refractory primary adhesive capsulitis. Patients were allocated
into two groups: Group A underwent arthroscopic capsular release with subacromial decompression, rotator interval release and MUA, while
Group B underwent MUA alone. Patients were followed for a minimum of six months. Pain was assessed using the Visual Analog Scale, shoulder
range of motion was measured clinically, and functional outcomes were evaluated using the Constant–Murley score.
Results: Both groups showed significant postoperative improvement. However, group A demonstrated significantly greater pain relief, improved
range of motion in all planes, and higher Constant–Murley scores compared to group B (p < 0.05). Excellent to good functional outcomes were
observed in 85% of group A patients versus 50% in group B. Complication rates were low and comparable between groups.
Conclusion: Arthroscopic capsular release combined with subacromial decompression, rotator interval release, and MUA provides superior
functional outcomes compared to MUA alone in refractory primary adhesive capsulitis, with acceptable safety and reliability.