Comparison of clinical outcomes between arthroscopic debridement and conservative treatment of primary adhesive capsulit
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ORIGINAL PAPER
Comparison of clinical outcomes between arthroscopic debridement and conservative treatment of primary adhesive capsulitis of the hip Jae-Young Lim 1 & Yoshi Pratama Djaja 2 & Yoo-Sun Won 3 & Eui-Chan Jang 3 & Jae Yoon Kim 3 & Yong-Chan Ha 3 Received: 25 November 2019 / Accepted: 11 June 2020 # SICOT aisbl 2020
Abstract Purpose The purpose of this study was to assess the clinical outcomes and change of ROM between patients with adhesive capsulitis of the hip (ACH) who underwent arthroscopic treatment and those who underwent conservative treatment at a minimum follow-up of two years. Methods From 2010 to 2017, 35 hips (32 patients, 10 men and 22 women) diagnosed with primary ACH were enrolled and followed up for a minimum of two years. Arthroscopic surgery was performed in 17 patients (20 hips, operation group), and conservative treatment was performed in 15 patients (15 hips, control group). Outcomes were measured with the visual analogue scale (VAS), University of California, Los Angeles (UCLA) activity scale, modified Harris hip score (mHHS), and degree of range of motion (ROM). Results The patients in the operation group were younger than those in the control group (mean age, 36.6 vs 46.2, p = 0.032). The VAS scores were significantly lower in the operation group than in the control group at two weeks, six weeks, and 24 months of follow-up. Moreover, the operation group showed a trend of better values of UCLA and mHHS, with no statistical differences during the entire follow-up; these patients also achieved greater improvements of external rotation at six weeks’ evaluation. Conclusion The patients with ACH in the two groups shows improvement of pain, UCLA scale, mHHS, and ROM at a minimum two year follow-up. Based on this study, we do not routinely recommend surgical treatment. However, patients with intractable pain and severe limitation of ROM are possible candidate of arthroscopic capsular release. Keywords Adhesive capsulitis . Arthroscopy . Conservative treatment . Hip . Clinical outcome
Introduction Adhesive capsulitis of the hip is an uncommon disease entity and is similar to the pathological condition and clinical characteristics of adhesive capsulitis of the shoulder. Byrd and Jones [1] described adhesive capsulitis of the hip (ACH) as a “clearly identifiable entity” that is similar to adhesive
* Yong-Chan Ha [email protected] 1
Department of Orthopaedic Surgery, Inje University Haeundae Paik Hospital, Busan, South Korea
2
Department of Orthopaedic and Traumatology, Fatmawati General Hospital, Jakarta, Indonesia
3
Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-ku, Seoul 06973, South Korea
capsulitis of the shoulder (ACS). ACH is characterized by a painful decrease in active and passive range of motion (ROM) as synovial inflammation in the acute stages of the disease progresses to capsular fibrosis in the chronic stages. In 1963, Caroit et al. [2] first reported on capsular constriction of the hip. Thereafter, several studie
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