Correlation Analysis Between The Postoperative Outcome And The Preoperative Duration Of Symptoms Of Frozen Shoulder Treated By Arthroscopic Shoulder Release

Objective: To investigate the clinical efficacy of arthroscopic shoulder release in the treatment of frozen shoulder and the correlation between the postoperative outcome and the preoperative duration of symptoms of patients.Materials and Methods: A retrospective self-controlled study was conducted to select 34 patients with frozen shoulders who underwent arthroscopic shoulder release in the same treatment group from September 2015 to November 2017,including males.12 cases,22 women;20 cases of left shoulder,14 cases of right shoulder;mean age 54 years;mean disease duration was 5 months.Pain visual score(VAS),active shoulder mobility(ROM),Constant-Murley(C-M)shoulder function score,American Shoulder and Elbow Surgery Association(ASES)shoulder function score and UCLA(University of Califonia,Los Angeles)shoulder function score were compared between preoperative and the final follow-up.The correlation and linear regression between the shoulder function scores at the final follow-up of the patients and the duration of the presenting symptoms was analyzed.Results: Thirty-four patients were followed up for 12-37 months,with an average followup of 25 months.33 patients(97%)achieved good clinical outcomes,and 1 patient had persistent mild shoulder pain and limited mobility.The patient's preoperative VAS score was 9(7.75 9.25),and the last follow-up fell to 0(0 1),with statistically significant differences(p < 0.05).The active flexion,abduction and external rotation by the side of the patient at the final follow-up were restored to 160.44±9.24,158.06 ± 8.92,57.06 ± 10.08 by preoperative 80.15±19.87,73.82±19.23,16.03±11.53,respectively,and the medial internal rotation by the side also recovered from the preoperative hip level to the T12 level,with statistically significant differences(p < 0.05).The UCLA shoulder function score increased from preoperative 12.00(10.00 15.00)to 35.00(30.75 35.00)at the final follow-up;the C-M shoulder function score increased from 29.50(25.00 36.00)to 96(84.75 98.00);ASES shoulder function score was increased by preoperative 18.33(16.25 33.33)to 95.00(88.33 98.33),all of the differences were statistically significant(p < 0.05).There was no significant correlation between preoperative UCLA,C-M and ASES shoulder function scores and duration of symptoms of patients.The UCLA,C-M,and ASES shoulder function scores at the final follow-up were linearly negatively correlated with the preoperative duration of symptoms of patients.(UCLA: r=-0.443,p=0.0086;R2=0.357,p=0.0002.C-M: r=-0.502,p=0.0025;R2 =0.393,p<0.0001.ASES: r=-0.538,p=0.0010;R2=0.388,p<0.0001.)Conclusion: Arthroscopic shoulder release is an effective method for treating frozen shoulders,and there was a significant linear negative correlation between the postoperative outcome of arthroscopic shoulder release and the preoperative duration of symptoms of the frozen shoulder patients.The longer the patient's course of disease,the worse the postoperative effect.Therefore,In order to obtain better curative effect,arthroscopic shoulder release should be performed as soon as possible when the outcome of conservative treatment is not significant for frozen shoulder patients.