Outcomes Following Capsular Distention for Stage II Adhesive Capsulitis

Author(s): Alyssa Pelak, Amier Hassan, Arnav Barve, Antonio Madrazo-Ibarra, Jonathan Kirschner, Vijay B. Vad

Background: There has been many different treatments for adhesive capsulitis explored including physical therapy, manipulation under anesthesia, arthroscopic capsular release, corticosteroid injections, and capsular distention without consensus regarding the most effective treatment. Capsular distention has not been explored in a mid-term study. Therefore, this study aims to investigate the mid-term outcomes of the procedure and analyze the need for a second procedure following initial distention.

Methods: This study included 27 patients with average age of 58 diagnosed with stage II adhesive capsulitis. The primary outcome was the rate of second procedures in patients following initial capsular distention, utilizing both electronic medical record and direct patient questions. The secondary outcomes included patient satisfaction rating, range of motion (ROM) limitations, limitations on Activities of Daily Living (ADLs) and time to follow up.

Results: At an average follow up of 49 months, 78% of patients did not require a second procedure following capsular distention. The group that required second procedure had a significantly higher percentage of hypothyroid patients and a shorter time to follow up visits. Additionally, 81% of the total cohort reported their outcomes as “good,” 74% had no ROM limitations and 89% had no limitations on ADLs.

Conclusion: Capsular distention shows promising results for mid-term follow up with patient reported outcomes and over three quarters of patients not requiring a second procedure. Further research on the use of this treatment is warranted including randomized controlled trials and longer term follow up.