Mlv SK, Mittal R, Chauhan N. Arthroscopic findings after manipulation under anesthesia in idiopathic capsulitis of the shoulder: A prospective study. World J Clin Cases 2023; 11(34): 8147-8152 [PMID: 38130786 DOI: 10.12998/wjcc.v11.i34.8147]
Corresponding Author of This Article
Ravi Mittal, FRCS, MBBS, MS, Doctor, Professor, Senior Lecturer, Surgeon, Department of Orthopaedics, All India Institute of Medical Sciences, Sri Aurobindo Marg, Ansari Nagar, New Delhi 110029, India. ravimittal66@hotmail.com
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Otorhinolaryngology
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Prospective Study
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Mlv SK, Mittal R, Chauhan N. Arthroscopic findings after manipulation under anesthesia in idiopathic capsulitis of the shoulder: A prospective study. World J Clin Cases 2023; 11(34): 8147-8152 [PMID: 38130786 DOI: 10.12998/wjcc.v11.i34.8147]
World J Clin Cases. Dec 6, 2023; 11(34): 8147-8152 Published online Dec 6, 2023. doi: 10.12998/wjcc.v11.i34.8147
Arthroscopic findings after manipulation under anesthesia in idiopathic capsulitis of the shoulder: A prospective study
Sai Krishna Mlv, Ravi Mittal, Nitin Chauhan
Sai Krishna Mlv, Department of Orthopaedics, Aayush Hospital, Eluru 534002, Andhra Pradesh, India
Ravi Mittal, Nitin Chauhan, Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
Author contributions: Mlv SK and Chauhan N contributed to the data acquisition, initial manuscript drafting, and incorporating revisions of this manuscript; Mittal R participated in the conception, supervision, and critical analysis and was the primary surgeon of this study.
Institutional review board statement: The study was approved by the institutional ethical committee (IESC/T-300/02.08.2013).
Clinical trial registration statement: We have not done any intervention or any randomization as a part of our study. We have only documented the findings observed during the procedure. The same was documented in the consort statement.
Informed consent statement: Informed consent was obtained from all the patients.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Corresponding author: Ravi Mittal, FRCS, MBBS, MS, Doctor, Professor, Senior Lecturer, Surgeon, Department of Orthopaedics, All India Institute of Medical Sciences, Sri Aurobindo Marg, Ansari Nagar, New Delhi 110029, India. ravimittal66@hotmail.com
Received: September 1, 2023 Peer-review started: September 1, 2023 First decision: September 20, 2023 Revised: September 30, 2023 Accepted: November 21, 2023 Article in press: November 21, 2023 Published online: December 6, 2023 Processing time: 95 Days and 20.9 Hours
Abstract
BACKGROUND
Manipulation under anesthesia (MUA) of the shoulder joint is a commonly used method for the treatment of adhesive capsulitis. Though it has been known to be associated with a variety of complications, there is a paucity of studies describing the arthroscopic findings after MUA.
AIM
To describe the arthroscopic findings in patients with idiopathic adhesive capsulitis of the shoulder after MUA.
METHODS
We recruited 28 patients with idiopathic adhesive capsulitis who underwent arthroscopic capsular release. Manipulation of the shoulder was performed under anesthesia in all of these patients before capsular release. Intra-articular findings were recorded during arthroscopic capsular release in these patients.
RESULTS
All patients showed the presence of synovitis. Twenty-seven patients showed tears in the capsule on the anterior aspect. One patient had an avulsion of the anterior rim of the glenoid and labrum following the manipulation. Four patients had partial rotator cuff tears, and one patient showed a superior labrum anterior posterior lesion, which was not diagnosed preoperatively on magnetic resonance imaging.
CONCLUSION
MUA leads to rupture of the capsule, which is the desired outcome. However, the site of rupture of the capsule is dependent on the maneuvers of MUA. In addition, partial tears of the rotator cuff and osteochondral fractures of the glenoid can also occur.
Core Tip: Manipulation under anesthesia for a frozen shoulder can lead to damage to other intra-articular structures besides the rupture of the capsule, which is the main aim of this procedure. In most cases, it leads to rupture of the anterior capsule. This is the same area where arthroscopic releases are most often performed. Rupture of the posterior and inferior capsule can also occur depending on the rotational and adduction manipulation of the shoulder.
