Wednesday, February 16, 2011

Adhesive Capsulitis A Review of Current Treatment

Adhesive Capsulitis

A Review of Current Treatment

  1. Andrew S. Neviaser, MD and
  2. Jo A. Hannafin, MD, PhD*

+Author Affiliations

  1. Hospital for Special Surgery, New York City, New York
  1. *Jo A. Hannafin, MD, PhD, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 (e-mail: hannafinj@hss.edu).

Abstract

Adhesive capsulitis is characterized by a painful, gradual loss of both active and passive glenohumeral motion resulting from progressive fibrosis and ultimate contracture of the glenohumeral joint capsule. Variable nomenclature, inconsistent reporting of disease staging, and a multitude of different treatments have created a confusing and contradictory body of literature about this condition. Our purpose is to review the evidence for both nonsurgical and surgical management of adhesive capsulitis with an emphasis on level I and II studies when available. Significant deficits in the literature include a paucity of randomized controlled trials, failure to report response to treatment in a stage-based fashion, and an incomplete understanding of the disease’s natural course. Recognition that the clinical stages reflect a progression in the underlying pathological changes should guide future treatments.



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