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Backgrounds: The lack of systematic classification and standard treatment principles for knee ankylosis prevents optimal treatments. This study explored treatments for type I (mild) knee joint ankylosis. Method: This retrospective study analysed patients with knee joint ankylosis admitted from March 2013 to January 2018 who underwent sequential arthroscopic release. Result: The 62 patients had 12–36 (average, 18) months of follow‐up. Thirty‐eight patients were released; of these, 18 were assisted by limited incision with partial quadriceps femoris expansion myotomy and released according to arthroscopy. Six patients underwent lengthening and release of the quadriceps femoris. All surgeries combined with full‐course rehabilitation resulted in improved joint mobility. The range of motion (ROM) of the knee joint recovered to a range of 0° to 85°‐140° (mean: 118.32 ± 9.42°) from the preoperative range of 30°–70° (mean: 45° ± 15.50°). The clinical effect was evaluated according to the Judet criteria at the final follow‐up. The outcomes at the last follow‐up (at least for 1 year) were excellent in 55 cases, good in six cases, and fair in one case. Conclusion: Sequential arthroscopic release, minimal selective invasion of limited incision of partial quadriceps femoris expansion myotomy, assisted by pie‐crusting technique to release, or quadriceps femoris lengthening, and release surgery for type I knee joint ankylosis, accompanied by early rehabilitation training provided satisfactory results without significant complications. [ABSTRACT FROM AUTHOR]

Abstract Purpose This study aimed to perform a systematic review and meta-analysis to compare the clinical outcomes of open surgery and arthroscopic release in gluteal muscle contracture (GMC). Methods Two independent reviewers YM and WL conducted a systematic search of PubMed, Embase, Cochrane Library, and Web of Science to identify clinical trials that adhered to the PRISMA guidelines (Appendix A), spanning from inception to July 2023. Search items included ((“gluteal” OR “gluteus”) AND (“contracture” OR “fibrosis”)). Research comparing open surgery or arthroscopic release was included. Clinical outcomes were compared using the risk ratio for dichotomous variables and the standardized mean difference for continuous variables. A P value

Introduction: Tennis elbow management has primarily been conservative over the years with over 90% of the cases being managed conservatively. Surgical intervention may be necessary only for symptomatic recalcitrant cases of tennis elbow cases. However, there are gaps in the literature when it comes to comparison of the return to pre-operative return to their work and level of activities among patients who undergo arthroscopic management and those who receive conservative management. Methods: A retrospective observational study was conducted to compare 23 patients receiving continued intensive conservative (CIC) management in group 1 with 24 patients undergoing arthroscopic release of the extensor carpi radialis brevis and lateral epicondyle decortication (ARD) in group 2. The study had a minimum follow-up period of 3.5 years. The researchers compared the groups in terms of return to work (RTW) at the same intensity or lower level and any changes in their previous work. Objective grip strength and patient-reported outcome measures, such as post-intervention satisfaction level (rated on a scale of 0–100) and visual analog scale (VAS) for residual elbow pain, were also compared between the two groups. Results: Return to work (RTW) occurred significantly earlier in group 2 (mean 6.13 months) compared to group 1 (mean 4.64 months), and a greater number of patients in group 2 (13/24, 54.2%) were able to return to the same of work. Although not statistically significant, the ARD group exhibited comparable patient satisfaction (p = 0.62) and visual analog scale (VAS) scores for residual elbow pain (p = 0.67). Grip strength was comparable (p = 0.084, 0.121) between the affected and unaffected sides of the bilateral upper extremities and among both groups of patients. Conclusion: The use of ARD for RTE (recalcitrant tennis elbow) indicates a significantly earlier return to work (RTW) at the same or lower intensity level compared to the standard CIC therapy protocol. Objective grip strength was comparable to the non-affected side and among the two groups of patients receiving two different management modalities. Comparable patient-reported satisfaction and residual lateral elbow pain were also noted among both the groups. Level of evidence: Retrospective, comparative study, level III. [ABSTRACT FROM AUTHOR]

Abstract Background There has been no ideal treatment for freezing-phase frozen shoulder to rapidly relieve pain and improve joint mobility. No any other team directly compared the effectiveness of combination of arthroscopic release and corticosteroid hydrodilatation with corticosteroid hydrodilatation only in treatment of freezing-phase frozen shoulder. Methods Seventy-two patients with freezing-phase frozen shoulder were randomly assigned to combined arthroscopic release with corticosteroid hydrodilatation (group A) or corticosteroid hydrodilatation only (group B). Clinical states were examined at baseline and periodically (Weeks 1, 4, 12, 24 and 1 year) after intervention by passive ROM; visual analog scale (VAS); UCLA and Disabilities of the Arm, Shoulder, and Hand (DASH) score. Results The passive ROM, VAS, UCLA and DASH scores always improved along the time points (all p 0.01), the differences between group A and group B were all lower than minimal clinically important difference (MCID). At Week 12, the UCLA sores and DASH scores were 26.8 ± 3.8, 14.2 ± 2.0 in group A versus 22.3 ± 3.4, 22.5 ± 3.1 in group B (all p

Background: There has been no ideal treatment for freezing-phase frozen shoulder to rapidly relieve pain and improve joint mobility. No any other team directly compared the effectiveness of combination of arthroscopic release and corticosteroid hydrodilatation with corticosteroid hydrodilatation only in treatment of freezing-phase frozen shoulder. Methods: Seventy-two patients with freezing-phase frozen shoulder were randomly assigned to combined arthroscopic release with corticosteroid hydrodilatation (group A) or corticosteroid hydrodilatation only (group B). Clinical states were examined at baseline and periodically (Weeks 1, 4, 12, 24 and 1 year) after intervention by passive ROM; visual analog scale (VAS); UCLA and Disabilities of the Arm, Shoulder, and Hand (DASH) score. Results: The passive ROM, VAS, UCLA and DASH scores always improved along the time points (all p < 0.01). The passive abduction (pAB), passive forward flexion (pFL), passive external rotation (pER), passive internal rotation (pIR) were better in group A than in group B at Week 1, 4, 12, 24 (all p < 0.01). At 1 year post-operation, the pFL and pIR were better in group A than in group B (all p < 0.01). VAS scores of group A were similar with those of group B (all p > 0.01), the differences between group A and group B were all lower than minimal clinically important difference (MCID). At Week 12, the UCLA sores and DASH scores were 26.8 ± 3.8, 14.2 ± 2.0 in group A versus 22.3 ± 3.4, 22.5 ± 3.1 in group B (all p < 0.01). At Week 24 post-operation, there were 32.7 ± 2.0, 9.8 ± 1.5 in group A versus 26.3 ± 3.6, 17.5 ± 3.5 in group B (all p < 0.01). At 1 year post-operation, there were 34.5 ± 0.8, 1.7 ± 1.5 in group A versus 32.1 ± 2.3, 8.8 ± 2.8 in group B (all p < 0.01), the differences of UCLA scores between group A and group B at Week 24 was higher than the MCID. There were no complications such as infection, nerve or vascular injury. Conclusions: Combined arthroscopic release with corticosteroid hydrodilatation would yield better results in passive ROM and function than corticosteroid hydrodilatation only. Trial registration: ChiCTR1900024235, July 2, 2019 (Retrospectively registered). [ABSTRACT FROM AUTHOR]

Introduction: Lateral patellar compression syndrome is one of the causes of anterior knee pain in young adults and resulted from tight lateral patellar retinaculum. The aim of our study is to compare between open and arthroscopic release of lateral patellar compression syndrome in relation of functional outcome, time of surgical procedure, length of hospital stays, intraoperative and postoperative complications as bleeding, infection, recurrence, and patellar instability with 2 years of follow-up. Materials and methods: 80 patients, age (21–49 years), were divided randomly into 2 groups (A and B). Group A (40 patients) were treated with open release. Group B (40 patients) were treated by arthroscopic release. All these patients are diagnosed as lateral patellar compression syndrome depending on clinical features and MRI. All patients were assessed by Lysholm knee scoring scale before surgery and at periods of 2, 6 weeks, 6, 12, and 24 months after surgery. Results: There is significant difference in functional outcome, measured by Lysholm knee scoring scale, between preoperative and postoperative assessment periods in both groups (P < 0.001). There is significantly better functional outcome at 2 years of follow-up with arthroscopic release (P = 0.018). There is no recurrence in both groups, but there were 4 patients develop medial patellar instability in the group of open release. Conclusion: Both open and arthroscopic lateral release for patients with isolated lateral patellar compression syndrome can be effective surgical procedures, but arthroscopic release can achieve better functional outcome. Trial registration: NCT, NCT04130412. Retrospectively registered on 3rd of June, 2020 at ClinicalTrials.gov. [ABSTRACT FROM AUTHOR]

Abstract Background Degenerative cartilage changes can be seen, in cases of lateral patellar compression syndrome, involving the patellofemoral joint. Hyaluronic acid is a natural component of the synovial fluid and responsible for its elastic features and function of articular surfaces. The aim of this study is to show the effect of intra-articular injection of Hyaluronic acid, after arthroscopic lateral release in lateral patellar compression syndrome, on the functional outcome and knee pain in those patients with degenerative cartilage changes. Method Ninety patients age (30–50) years with lateral patellar compression syndrome and degenerative cartilage changes were divided randomly into 2 groups. Group A was treated by arthroscopic lateral release and received intraarticular injection of Hyaluronic acid 2 weeks after surgery. Group B was treated by arthroscopic lateral release only. Both groups were assessed by Kujala score and visual analogue scale for knee pain preoperatively and re-assessed postoperatively at 3 months, 6 months, 12 months and 24 months. Results There was significant improvement in Kujala score and Visual analogue scale post-operatively in both groups (P-value

Background: Lateral epicondylitis of the elbow is a common degenerative disorder in middle-aged patients. Surgery is reserved for patients who do not respond to nonoperative treatment. Purpose: To evaluate hand-grip strength and return to heavy manual activities in patients engaged in work requiring heavy lifting after arthroscopic release of refractory lateral epicondylitis. Study Design: Case series; Level of evidence, 4. Methods: The study included consecutive patients who underwent arthroscopic release of the extensor carpi radialis brevis tendon to treat recalcitrant lateral epicondylitis of the elbow, with a minimum 48-month follow-up. Functional outcome measures included assessment of hand-grip strength, visual analog scale for pain, and Mayo elbow performance score. The recorded measurements were compared at postoperative 1 and 6 months and the final assessment. Pre- and postoperative data were compared using the paired t test, and the various postoperative assessments were compared using 1-way analysis of variance. Results: A total of 22 patients (mean ± SD; age, 34.6 ± 5.9 years) with a mean follow-up of 60.5 ± 4.7 months were included in our study. There were highly significant improvements between preoperative and 1-month postoperative results regarding hand-grip strength (17.5 ± 4.1 kg to 34.4 ± 6.8 kg), visual analog scale score for pain (7.86 ± 1.2 to 1.8 ± 1.09), and Mayo score (57.1 ± 7.9 to 89.3 ± 4.9; P <.00001 for all). Significant improvements were found on all 3 functional measures between 1 and 6 months postoperatively (P ≤.05 was statistically significant), and there were nonsignificant improvements on all measures from 6-month to final follow-up. The patients regained 96.4% of their hand strength as compared with the unaffected side and returned to their previous activities without reporting serious complications. Conclusion: Minimally invasive arthroscopic release of recalcitrant lateral epicondylitis of the elbow provided a satisfactory functional result, as shown by regaining of hand-grip strength in patients engaged in heavy manual occupations without significant morbidities. [ABSTRACT FROM AUTHOR]

Introduction Restricted range of motion over the knee joint is a known complication following the surgical procedure. Aggressive rehabilitation protocols can initially manage knee stiffness due to arthrofibrosis. If conservative management fails, surgical (open or arthroscopic) release is the preferred modality of management. We present a series of 40 patients with postoperative knee stiffness who were treated with arthroscopic adhesiolysis. Material and methods This is a retrospective study conducted at Phoenix Orthopedic Superspeciality Hospital, Nagpur, India, from 2017 to 2021. Our study included 40 patients with postoperative knee joint stiffness, of whom 27 were males and 13 were females. The study considered the duration of stiffness, which ranged from six months to five years. All patients underwent arthroscopic knee release. A rigorously supervised physical therapy program followed this procedure. Patients were examined at three months, six months, and one year to assess improvement in knee range of movement. Results Out of 40 patients, six were classified as Shelbourne type 4, and the remaining were Shelbourne type 3. Twenty-three of 40 patients developed arthrofibrosis following intra-articular or peri-articular fracture fixation surgery; 11 patients were operated on arthroscopically for anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) reconstruction. Three patients developed stiffness following total knee replacement, one following patellectomy, and three following infection after fracture fixation. The mean pre-op knee range of motion (ROM) was 48.875 degrees. Following arthroscopic release, the mean improvement in ROM was 60 degrees intra-operatively. The average postoperative range was 108.25 degrees. Conclusion Arthroscopic adhesiolysis and quadriceps release are reliable methods for dealing with postoperative knee stiffness. It prevents wound complications and increases the chances of surgical site infection due to smaller incisions. Postoperatively, we achieved an average increase of 60 degrees in ROM over the knee joint., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sapre et al.)

Specific information to guide clinical practice is lacking for the effects of arthroscopic release on bone and joint deformities, as well as the additional benefits of tendon transfer, in children with brachial plexus birth injury. The aims of this study were (1) to evaluate changes in shoulder mobility and bone and joint deformity, (2) to evaluate the effect of release with and without tendon transfer on the same outcomes, and (3) to evaluate the perioperative and long-term complications. We conducted a systematic review and meta-analysis. Four databases were searched using relevant inclusion and exclusion criteria from inception until May 2020. The quality of articles was evaluated using the Methodological Index for Non-randomized Studies (MINORS) scale. Data regarding patients, interventions, and clinical and radiologic outcomes were reported. Thirteen articles were included: 6 of low quality and 7 of moderate quality separated into 17 studies (266 children). The mean follow-up duration was 32.4 months (standard deviation, 15.2 months). Arthroscopic release significantly improved the Mallet score (standardized mean difference [SMD], 3.1 [95% confidence interval (CI), 1.5-4.7]; P <.001) and passive external rotation (SMD, 3.6 [95% CI, 2.3-4.9]; P =.02). The percentage of humeral head anterior (SMD, 1.3 [95% CI, 0.7-1.9]; P =.003) and glenoid retroversion (SMD, 1.4 [95% CI, 0.9-2]; P =.01) also improved. Descriptive analysis of the data suggested that concomitant tendon transfer further improved mobility. Recurrence of internal-rotation contracture was reported in 8 of 157 children. This systematic review showed that arthroscopic release effectively improves both shoulder mobility and bone deformity, with few complications in young children with brachial plexus birth injury. As such, it seems reasonable to propose a stepwise approach starting with a release without transfer. [ABSTRACT FROM AUTHOR]

Background: Degenerative cartilage changes can be seen, in cases of lateral patellar compression syndrome, involving the patellofemoral joint. Hyaluronic acid is a natural component of the synovial fluid and responsible for its elastic features and function of articular surfaces. The aim of this study is to show the effect of intra-articular injection of Hyaluronic acid, after arthroscopic lateral release in lateral patellar compression syndrome, on the functional outcome and knee pain in those patients with degenerative cartilage changes.Method: Ninety patients age (30-50) years with lateral patellar compression syndrome and degenerative cartilage changes were divided randomly into 2 groups. Group A was treated by arthroscopic lateral release and received intraarticular injection of Hyaluronic acid 2 weeks after surgery. Group B was treated by arthroscopic lateral release only. Both groups were assessed by Kujala score and visual analogue scale for knee pain preoperatively and re-assessed postoperatively at 3 months, 6 months, 12 months and 24 months.Results: There was significant improvement in Kujala score and Visual analogue scale post-operatively in both groups (P-value< 0.001) with better improvement in Kujala score in group A after intra-articular injection of Hyaluronic acid up to 2 year of follow up (P-value = 0.006) as well as better improvement in visual analogue score at 6 months post-operatively (P-value = 0.035).Conclusion: Intra-articular injection of Hyaluronic acid after arthroscopic release, in patients with lateral patellar compression syndrome and degenerative cartilage changes, can result in better improvement of knee pain and functional outcome up to 2 years of follow up.Trial Registration: NCT, NCT04134611 . Registered 18 October 2019 -Retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: Lateral epicondylitis is a common cause of lateral elbow pain; characterized as an overuse injury of the forearm and the wrist extensors. The elbow arthroscopy has an important role for diagnosing and treating many elbow disorders. Objective: The aim of this study was to evaluate the effectiveness of the arthroscopic intervention as a minimally invasive procedure in management of resistant cases with tennis elbow after failure of conservative treatment. Material and methods: A prospective study included 30 patients with resistant lateral epicondylitis treated with arthroscopic debridement of extensor carpi radialis brevis tendon. This study was carried out in the period between January 2017 and February 2019 at Al Azhar University Hospitals. The patients were evaluated pre-, intraand post-operatively for their elbow function and pain using the following scores: Mayo Elbow Performance Index (MEPI), Disability of the Arm, Shoulder and Hand (DASH), The Nirschl staging score and visual analog scale (VAS) for pain. Result: A total of 30 patients (12 male and 18 female) were included. The mean of MEPI score improved from 71.33 to 92.55, DASH score from 28.53 to 3.18, Nirschl scale improved from 4.13 to 1.47 and pain VAS improved from 5.27 to 1.47. There was a significant difference between from before to after surgery for the four functional scores. 2 patients complicated with ulnar nerve injury. Conclusion: The arthroscopic treatment of tennis elbow was shown to be an effective therapeutic option when appropriately indicated and performed in refractory cases. It also allowed excellent viewing of joint space for diagnosis and treatment of any associated pathological conditions with a minimally invasive procedure. [ABSTRACT FROM AUTHOR]

Background: To compare the effects of conservative steroid injection and arthroscopic capsular release during early intervention of stages I and II of primary frozen shoulder (PFS). Methods: A randomized controlled clinical trial was conducted. Thirty-six stage I and 32 stage II patients were randomly allotted to a steroid injection and an arthroscopic treatment groups and followed up for 12 months. The outcomewas evaluated using visual pain scale (VAS), the American Shoulder and Elbow Surgeon (ASES) score, shoulder active range of motion (ROM) prior to treatment, and 3weeks and 3 and 12 months post-treatment. Results: All the subjects in stages I and II PFS groups showed similar shoulder pain and function scoring before treatment. Among stage I patients, conservative treatment showed higher VAS, ASEA and ROM scores 3 weeks post-treatment. Better VAS and ASEA scores were observed in the arthroscopic treatment group with 3 months post-treatment. Patients treated by arthroscopy showed better performance on all the clinical outcomes with 12 months post-treatment, compared with conservative treatment group. In stage II patients, conservative treatment showed better therapeutic effects compared with arthroscopic treatment with 3 weeks post-treatment. Arthroscopic treatment led to better performance on backward extension and forward flexion with 3 months post-treatment. Arthroscopic patients so treated showed better performance on all the clinical outcomes with 12 months posttreatment, compared with conservative treatment group. Conclusion: In early PFS patients, especially for stage II cases, arthroscopic treatment can better improve shoulder joint ROM, relieve pain, and enhance function, compared with steroid injection treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVE: Frozen shoulder is a common condition, characterized by pain and restrictions in shoulder movements. Different non-surgical and surgical methods are used to overcome this condition. Given the high prevalence of frozen shoulder among the working class in communities, re-empowerment is essential for individuals’ return to daily activities. Considering the contradictory results reported by previous research, further investigations are required in this area. Therefore, this study aimed to evaluate the clinical findings of arthroscopic release in treatment of primary frozen shoulder. METHODS: This cross-sectional study was performed on all patients with primary frozen shoulder, referring to Bahonar and Shafa Hospitals of Kerman, Iran. These patients were candidates for surgery due to unsuccessful supportive treatment. First, American Shoulder and Elbow Surgeons (ASES) assessment form (score: 0-100) and Simple Shoulder Test (a 12-item questionnaire) were completed before surgery. Then, all patients underwent arthroscopic release and examinations. The assessment forms were completed again within 3 and 12 months after surgery. FINDINGS: Overall, 15 patients with the mean age of 50.57±12.01 years were included in this study. There was a significant difference in the mean score of SST before (10.21±0.98) and after (10.98±1.05) surgery (p=0.034). Also, patients’ performance at 12-month follow-up significantly improved, compared to the three-month follow-up (p=0.014). There was a significant difference in the mean scores of ASES test before and after surgery (p=0.007). Also, the mean score of ASES test was higher at 12-month follow-up, compared to the three-month follow-up (p=0.019). CONCLUSION: Overall, arthroscopic release could help relieve pain and improve the range of shoulder movements in patients. Moreover, it could help patients return to their daily activities and regain their productivity. In fact, this technique facilitates simultaneous diagnosis and treatment of shoulder joint problems.

Background: Post-traumatic elbow stiffness (PTES) may substantially affect the patient's functional range of motion and quality of life. Open elbow release has been extensively studied, but arthroscopic techniques are limited, particularly in differentiating between post-traumatic and non-traumatic stiffness. The purpose of this study is to assess the clinical outcomes after arthroscopic release of PTES regarding the range of motion (ROM), pain, functional assessment, and complications., Methods: A prospective cohort was conducted on adult patients who underwent arthroscopic arthrolysis for PTES, with 32 patients included in the final analysis. The ROM was measured using the orthopedic goniometer. Grip strength was measured using the Camry digital hand dynamometer (Camry, CA, USA) and compared to their contralateral side. The functional status of the patients was evaluated using the American Shoulder and Elbow Surgeons Score (ASES)andthe Mayo Elbow Performance Index (MEPI). All measurements were done before surgery and at the last follow-up visit. Pre-operative and post-operative changes in MEPI, ASES, and visual analog (VAS) scores were compared with the paired t-test., Results: After surgery, the ROM significantly improved from 74 ± 11 to 110 ± 15 degrees (p<0.001). Additionally, the ASES score and MEPI index both significantly improved from 69 ± 3.4 to 79 ± 6.3 and from 64 ± 5.7 to 82 ± 8, respectively (p<0.001). VAS scores also significantly improved from 1.1 ± 0.87 to 0.31 ± 0.53 at rest (p<0.001). The complication rate was 12%, including three transient ulnar nerve paresthesia and one superficial infection. Post-traumatic elbow release was more offered in distal humerus fractures (53%), followed by proximal ulna fracture/dislocations (25%)., Conclusion: We believe that arthroscopic arthrolysis is a safe and reliable treatment of PTES, which improves joint visibility and reduces pain. Patients can be counseled regarding the risk of a secondary surgery following distal humerus or proximal ulna fractures, including the expected recovery and complication rate., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Ghayyad et al.)

Background: Frozen shoulder is a common condition, characterized by pain and restriction in shoulder movements. Different non-surgical and surgical methods are used to overcome this condition. Given the high prevalence of frozen shoulder among the working class in communities, re-empowerment is essential for individuals to return to their daily activities. Considering the contradictory results reported by previous research, further investigations are required in this area. Therefore, this study aimed to evaluate the clinical findings of arthroscopic release in treatment of primary frozen shoulder. Methods: This cross-sectional study was performed on all patients with primary frozen shoulder, referring to Bahonar and Shafa hospitals of Kerman, Iran. These patients were candidates for surgery due to unsuccessful supportive treatment. First, American shoulder and elbow surgeons (ASES) assessment form (score: 0 - 100) and simple shoulder test (SST) (a 12-item questionnaire) were completed before surgery. Then, all the patients underwent arthroscopic release and examinations. The assessment forms were completed again 3 and 12 months after surgery. Results: Overall, 15 patients with the mean age of 50.57 ± 12.01 years were included in this study. There was asignificant difference in the mean score of SST before (10.24±0.98) and after (10.99±1.05) surgery (p=0.034). In addition, patients’ performance at 12-month follow-up significantly improved compared to the 3-month follow-up (P = 0.014). There was a significant difference in the mean scores of ASES test before and after surgery (P = 0.007). In addition, the mean score of ASES test was higher at 12-month follow-up compared to the three-month follow-up (P = 0.019). Conclusions: Arthroscopic release could help relieve pain and improve the range of shoulder movements in patients. Moreover, it could help patients return to their daily activities and regain their productivity. In fact, this technique facilitates simultaneous diagnosis and treatment of shoulder joint problems.

Copyright of Obere Extremitat is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Operative Orthopädie und Traumatologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Frozen shoulder is a specific, painful and debilitating condition effecting patients mainly in middle age. While it has been recognised for over 100 years, it is still mis-diagnosed, with a natural history that is poorly understood and with limited evidence for the efficacy for various treatments. This review considers what is known about this common painful condition and the treatments available. [Copyright &y& Elsevier]

Purpose: The purpose of this study was to compare the early clinical results of arthroscopic extensor carpi radialis brevis (ECRB) release with and without bone decortication in the treatment of lateral epicondylitis. Materials and methods: Thirty-eight patients who were surgically treated for lateral epicondylitis between 2004 and 2008 were included in this retrospective review. Among these 38 patients, 19 underwent arthroscopic ECRB release and 19 patients underwent both ECRB release with decortication of the lateral epicondyle. Outcome measures included pain assessment measured by visual analog scale (VAS) preoperatively, on postoperative day one, at two and 4 weeks postoperatively, and at the final follow-up visit. Functional evaluation was made with the Mayo Elbow Performance Index and grip strength measurement. Results: Patients who underwent simple ECRB release had significantly less pain than patients who underwent ECRB release and decortication immediately postoperatively ( p < 0.05). This group also showed a lower VAS score on exertion 2 weeks and 4 weeks after simple ECRB release ( p < 0.05). The mean time taken to return to work was 24.2 ± 18.3 days in the group that underwent simple ECRB release and 39 ± 22.7 days in the group that underwent ECRB release with decortication ( p < 0.05). Conclusions: Arthroscopic release of the ECRB is an effective method of treatment in patients with recalcitrant lateral epicondylitis. Decortication of the lateral epicondyle leads to increased pain postoperatively and did not improve clinical results. Level of evidence: Nonrandomized clinical trial, Level IV. [ABSTRACT FROM AUTHOR]

Copyright of Der Orthopäde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Inflammation and subsequent fibrosis, adhesions, or plicae may limit normal capsular compliance and decrease volume capacity of the knee.Hypothesis: Patients with fibrosis, anterior interval scarring, adhesions, or palpable painful plicae will have decreased knee volumes when compared to controls, and selective arthroscopic releases will restore volume to normal levels.Study Design: Descriptive laboratory study and cohort study; Level of evidence, 2.Methods: In part I, knee volume and pressure were recorded in 14 fresh-frozen human cadaveric knees, and the maximum volume capacity was identified before capsular disruption. In part II, 49 patients undergoing arthroscopy were divided into 2 groups based on intraoperative volume assessment at 50 mm H2O pressure: group 1 (n = 20) with normal volume (<1 standard deviation below the mean established in part I) and group 2 (n = 29) knees with deficient volume (>1 standard deviation below mean). Group 2 underwent volume-changing procedures such as lysis of adhesions, anterior interval release, and plica resections, while group 1 underwent volume-neutral procedures including meniscal or chondral surgery. The knee volume was then reassessed after arthroscopy.Results: The average volume capacity of the knees in the cadaveric study was 87.5 ± 21.7 mL (range, 50-120 mL). There was no statistical difference between the presurgical (98.9 ± 29.8 mL) and postsurgical volumes (99.4 ± 29.1 mL) in group 1; P = .65. The presurgical volume in group 2 (46.1 ± 13.0 mL) was significantly lower than group 1 (P = .001). The group 2 volume increased to 78.5 ± 24.2 mL after surgery (P = .001), with an average change in volume of 75.5%. The mean change in volume after surgery was significantly greater in group 2 (32.3 mL) versus group 1 (0.45 mL) ( P = .001). At 1-year follow-up, the mean Tegner score in the volume-compromised group 2 increased from 2.0 ± 1.4 preoperatively to 4.0 ± 2.0 postoperatively (P = .01), the Lysholm score increased from 45.0 ± 24.0 preoperatively to 76.8 ± 25.4 postoperatively (P = .003), and the average Short Form-12 quality of life score increased from 32.4 ± 8.7 preoperatively to 45.0 ± 11.0 postoperatively (P = .005).Conclusions: The average volume of the human knee in this study was between 65 and 110 mL (±1 standard deviation of mean of 87.5 mL). Although patients with chronic knee pain may have pain from multiple sources, some may have diminished knee volume, and selected arthroscopic releases can restore knee volume to near-normal levels. [ABSTRACT FROM PUBLISHER]

The clinical results of arthroscopic capsular release for frozen shoulder in diabetic (group 1) and idiopathic (group 2) patients were compared. Surgery was performed on 28 shoulders of 26 patients (24 women, 2 men) with frozen shoulder unresponsive to conservative treatment. The mean age was 50 (range 40–65). A total of 14 patients were included in group 1, and 12 were in group 2. The average duration of complaints was 10 and 7 months in groups 1 and 2, respectively. The evaluation of shoulder functions was made according to the University of California, Los Angeles (UCLA) and Constant Scoring Systems. Duration of complete pain relief and for regaining range of motion (ROM) after surgery were also noted in their final follow-up examination. The mean follow-up period was 48.5 and 60.2 months in group 1 and group 2, respectively. There was no significant difference between the two groups in terms of the postoperative duration of complete pain relief and that for regaining ROM ( P > 0.05). The duration of complete pain relief was 2.6 and 2.5 months, and regaining of ROM was 1.6 and 1.5 months for groups 1 and 2, respectively. The postoperative UCLA and Constant scores had significant increases in both groups compared to the preoperative ones ( P < 0.05). There was a significant difference between the groups in terms of Constant scores ( P < 0.05) while there was no difference in terms of UCLA scores ( P > 0.05). There was a statistically significant difference in shoulder abduction and internal rotation degrees between the groups ( P < 0.05). The results of arthroscopic capsular release for frozen shoulder in diabetic patients had less good results in terms of range of motion and Constant-Score. There was no significant difference between the two groups in terms of the duration of pain relief and that of regaining the ROM [ABSTRACT FROM AUTHOR]

Lateral epicondylitis occurs from repetitive motions of the upper extremity in both athletes and non-athletes, and is more recently thought to be related to overuse microtearing of the extensor carpi radialis brevis (ECRB). Less than 10% of all cases are recalcitrant and therefore nonresponsive to conservative management. Surgical treatment for tennis elbow consists of many open and arthroscopic techniques. Open repair aims to excise the diseased tissue, but requires longer postoperative recovery times. Arthroscopic treatment yields equally successful results as compared to open techniques. This article provides a brief overview of lateral epicondylitis and the current evidence for open versus arthroscopic treatment. [Copyright &y& Elsevier]

Arthroscopic release of the frozen shoulder is a reliable procedure when performed correctly and with the right surgical indications. The primary components of this technique include a scalene block and forward elevation manipulation followed by surgical release of the rotator interval and anterior-inferior capsule. Postoperative pain control for the first 48 hours is provided by an intraarticular pain catheter. Patients are instructed in shoulder range of motion exercises and provided with a continuos passive motion device. [ABSTRACT FROM AUTHOR]

Frozen shoulder is said to be a self-limiting entity but full recovery often takes more than 2 years. For that, most patients are unwilling to tolerate painful restriction while awaiting resolution. We prospectively investigated 30 patients (16 women, 14 men) for the outcome of arthroscopic capsular release in idiopathic frozen shoulder. Results were determined by the assessment of subjective and objective parameters to estimate both shoulder function and general health status. Symptoms persisted without improvement for a minimum of 6 months of conservative treatment. Preoperative average American shoulder and elbow surgeons score (ASES) was 35, visual analog scale (VAS) to measure pain was 7, and simple shoulder test (SST) was 4. Mean scores of the physical component of SF-36 were considerably reduced. Mean forward elevation was 85°, average abduction was 70°, mean internal rotation was 15°, and mean external rotation was 10°. Patients were followed-up at 6 weeks, 3, 6, 12 months and by a mean of 36 months. Range of motion for all planes improved ( P < 0.05). Median VAS reduced to 2, average ASES increased to 91, and SST enhanced to a mean of 10 ( P < 0.05). We stated improvement of the physical components in the SF-36 questionnaire in particular bodily pain and the role-physical score. There were no significant differences between the measurements in the early postoperative phase compared to the mid-term follow-up ( P > 0.05). Our results demonstrate that arthroscopic release of refractory idiopathic frozen shoulder combined with a gentle manipulation provides reliable expectations for improvement in both clinical and general health status for most patients. We recommend the use of a limb-specific and a general-health-status questionnaire to conclude the benefit of the surgical intervention and contribute the optimization of a therapy concept more effectively. [ABSTRACT FROM AUTHOR]

Background: Traditional surgical treatment for a painful snapping iliopsoas tendon has been an open lengthening of the tendon. Hypothesis: An endoscopic release will alleviate painful snapping of the tendon. Study Design: Case series; Level of evidence, 4. Methods: Six patients with painful snapping hips who had no pain relief after magnetic resonance arthrography, which included injection of bupivacaine into the hip joint, subsequently had an ultrasound evaluation of their iliopsoas tendons and an anesthetic injection into the psoas bursa. In all 6 patients, the injection relieved their hip pain, and in 4, real-time imaging demonstrated snapping of the tendon. All hips were evaluated with the 100-point Harris hip scoring system before and at 1 .5, 3, 6, and 12 months after surgery. Results: Preoperative hip scores averaged 58 points. After surgery, all patients had hip flexor weakness, used crutches for 5 weeks, and had 6-week scores that averaged 62 points. The patients continued to improve, and at 6 and 12 months, their scores averaged 90 and 96 points, respectively, and none had recurrence of their snapping or pain. Conclusion: Ultrasound-guided anesthetic injection of the psoas bursa is useful to confirm snapping of the iliopsoas tendon as the cause of a patient's hip pain. Endoscopic release of the tendon is a safe outpatient procedure that provides effective relief of the snapping and pain. [ABSTRACT FROM AUTHOR]