Introduction

Four weeks after the earthquake in Kashmir, multidisciplinary surgical teams were organised within the UK (MiST). The aim was to help with disaster victims who had been transferred to Rawalipindi. We reviewed the work carried by one such team from the 5-18 November 2005.

Introduction: Significant internal rotation limitation is thought to be due to posterior capsular thickening and therefore adding a posterior release to the anterior and inferior releases seems sensible. However, this is technically more difficult.

Aims: To assess the overall outcome of arthroscopic capsular release and to establish whether inclusion of a posterior capsular release has an additional beneficial.

Methods: 48 patients with primary or secondary frozen shoulder in whom conservative physiotherapy had failed were included. 27 had an anterior and inferior release only, whilst the 21 included a posterior release. All data was collected prospectively.

Results: Aetiology of the frozen shoulder was primary (22), diabetic (7), post-traumatic (7) and post-operative (11). There a highly significant improvement in Constant score (P < 0.001) and range of motion (P< 0.001) by 5 months in both groups. The mean satisfaction score (minimum 1 and maximum 10) was 7 post-operatively. There was no significant difference in Constant Score between the two groups (P = 0.56) and no significant difference in the improvement of the range of motion, in particular internal rotation (P=0.35).

Conclusion: There was an overall rapid significant improvement following arthroscopic capsular release, but no significant difference in the overall outcome with the addition of a posterior release.

Clinical relevance: Adding a posterior release to an arthroscopic capsulectomy does not seem to add any significant benefit to the outcome.