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[PMID]: 29191846 [Au] Autor: David M; Rangaraju M; Raine A [Ad] Endereço: The Royal Orthopaedic Hospital, Birmingham, UK michaeldavid@nhs.net. [Ti] Título: Acquired triggering of the fingers and thumb in adults. [So] Source: BMJ;359:j5285, 2017 11 30. [Is] ISSN: 1756-1833 [Cp] País de publicação: England [La] Idioma: eng [Mh] Termos MeSH primário: Deformidades Adquiridas da Mão/patologia Deformidades Articulares Adquiridas/patologia Tenossinovite/patologia Polegar/patologia Dedo em Gatilho/patologia [Mh] Termos MeSH secundário: Adulto Idoso Inglaterra/epidemiologia Feminino Deformidades Adquiridas da Mão/etiologia Deformidades Adquiridas da Mão/cirurgia Seres Humanos Injeções Subcutâneas Liberação da Cápsula Articular/métodos Deformidades Articulares Adquiridas/etiologia Deformidades Articulares Adquiridas/cirurgia Masculino Meia-Idade Estudos Observacionais como Assunto Prevalência Atenção Primária à Saúde/estatística & dados numéricos Esteroides/administração & dosagem Esteroides/uso terapêutico Tenossinovite/etiologia Polegar/cirurgia Dedo em Gatilho/tratamento farmacológico Dedo em Gatilho/etiologia Dedo em Gatilho/cirurgia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Steroids) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180305 [Lr] Data última revisão: 180305 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171202 [St] Status: MEDLINE [do] DOI: 10.1136/bmj.j5285

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[PMID]: 28259345 [Au] Autor: Yoo JC [Ti] Título: Editorial Commentary: Recalcitrant Idiopathic Adhesive Capsulitis of the Shoulder. [So] Source: Arthroscopy;33(3):509-510, 2017 Mar. [Is] ISSN: 1526-3231 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: An investigation of recalcitrant idiopathic adhesive capsulitis of the shoulder showed good outcomes with arthroscopic capsular release. However, it is critical that future authors carefully define the term "recalcitrant idiopathic adhesive capsulitis" so that we are speaking the same language and that future authors include a control (nonsurgical) treatment group to better determine whether surgery is truly superior to nonsurgical treatment. [Mh] Termos MeSH primário: Amplitude de Movimento Articular Articulação do Ombro/cirurgia [Mh] Termos MeSH secundário: Bursite/cirurgia Seres Humanos Liberação da Cápsula Articular Ombro [Pt] Tipo de publicação: EDITORIAL [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171026 [Lr] Data última revisão: 171026 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170306 [St] Status: MEDLINE

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[PMID]: 28135130 [Au] Autor: Nakagawa S; Iuchi R; Mae T; Mizuno N; Take Y [Ad] Endereço: Department of Orthopaedic Sports Medicine, Yukioka Hospital, Osaka, Japan. [Ti] Título: Clinical Outcome of Arthroscopic Bankart Repair Combined With Simultaneous Capsular Repair. [So] Source: Am J Sports Med;45(6):1289-1296, 2017 May. [Is] ISSN: 1552-3365 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: A capsular tear and humeral avulsion of the glenohumeral ligament lesion are not uncommon findings in association with a Bankart lesion. However, there have been few reports regarding the prevalence of such capsular lesions and the postoperative recurrence after capsular repair. Purpose/Hypothesis: This study investigated the prevalence of capsular lesions and clarified their influence on the postoperative recurrence of instability. In addition, factors were identified that were associated with the occurrence of capsular lesions and the postoperative recurrence of instability. We hypothesized that clinical outcomes would be improved by combining arthroscopic Bankart repair with simultaneous capsular repair. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Capsular lesions were retrospectively examined through operative records, still pictures, and videos in 172 shoulders with traumatic anterior instability. First, the prevalence of capsular lesions and their severity were investigated. Then, postoperative recurrence was determined in shoulders observed for a minimum of 2 years. Finally, factors were assessed that were associated with the occurrence of capsular lesions and the postoperative recurrence of instability. RESULTS: A capsular lesion was recognized in 37 shoulders (21.5%), being severe and mild in 20 and 17, respectively. All were repaired simultaneously with the arthroscopic Bankart procedure. After follow-up for at least 2 years, recurrence of instability was detected in 10 of 34 shoulders (29.4%), including 6 (31.6%) with severe capsular lesions and 4 (26.7%) with mild lesions. The recurrence rate was significantly higher in shoulders with a capsular lesion than in shoulders without a capsular lesion (18 of 120, 15%; P = .013), but there was no significant difference between severe and mild lesions. Regardless of the sport played, capsular lesions were significantly more frequent in patients ≥30 years old, patients with complete dislocation, and patients with a coexisting Hill-Sachs lesion. Postoperative recurrence of instability was significantly more frequent in patients <30 years and competitive athletes. CONCLUSION: In shoulders undergoing arthroscopic Bankart repair, capsular lesions were often present and were associated with higher postoperative recurrence of instability. While these lesions were more frequent in older patients, postoperative recurrence of instability was more likely in young competitive athletes. [Mh] Termos MeSH primário: Artroscopia/métodos Lesões de Bankart/epidemiologia Liberação da Cápsula Articular Cápsula Articular/cirurgia Articulação do Ombro/cirurgia [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Lesões de Bankart/cirurgia Estudos de Coortes Feminino Seres Humanos Masculino Meia-Idade Estudos Retrospectivos Cicatrização Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171027 [Lr] Data última revisão: 171027 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170131 [St] Status: MEDLINE [do] DOI: 10.1177/0363546516687752

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[PMID]: 27866795 [Au] Autor: Ranalletta M; Rossi LA; Zaidenberg EE; Campos C; Ignacio T; Maignon GD; Bongiovanni SL [Ad] Endereço: Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi, Italian Hospital of Buenos Aires, Buenos Aires, Argentina. [Ti] Título: Midterm Outcomes After Arthroscopic Anteroinferior Capsular Release for the Treatment of Idiophatic Adhesive Capsulitis. [So] Source: Arthroscopy;33(3):503-508, 2017 Mar. [Is] ISSN: 1526-3231 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: The purpose of this study is to report the early and midterm functional outcomes and complications of a consecutive series of patients with primary adhesive capsulitis who were treated with isolated anteroinferior arthroscopic capsular release after they did not respond to conservative treatment. METHODS: Thirty-two consecutive patients with idiopathic adhesive capsulitis who did not respond to conservative physiotherapy were included in the study. Arthroscopic anteroinferior capsular release was performed in all cases. The primary outcome was improvement in range of motion in the short- and midterm follow-up. We also evaluated pain relief with the visual analog scale, functional outcomes with the Constant-Murley score, and we registered postoperative complications. RESULTS: The mean age was 49.6 years (range, 33-68 years) and the mean follow-up was 63 months (range, 18-84). Overall, there was significant improvement in the Constant-Murley score from 42.4 to 86 points (P < .001). The visual analog scale decreased by approximately 6.3 points compared with the preoperative value (P < .001). All parameters improved significantly the first 6 months and then remained stable until the end of follow-up (P < .001). There was an additional minor improvement in both parameters between the sixth month and the final follow-up; however, this improvement was less than in the first 6 months and it was not statistically significant. CONCLUSIONS: In patients who don't respond to conservative treatment for primary adhesive capsulitis, isolated anteroinferior capsular release provides a reliable improvement in pain and range of motion that is maintained in the mid-term follow-up. LEVEL OF EVIDENCE: Level IV, therapeutic, case series study. [Mh] Termos MeSH primário: Artroscopia Bursite/cirurgia Liberação da Cápsula Articular Articulação do Ombro/cirurgia [Mh] Termos MeSH secundário: Adulto Idoso Feminino Seguimentos Seres Humanos Masculino Meia-Idade Amplitude de Movimento Articular Escala Visual Analógica Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170926 [Lr] Data última revisão: 170926 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161122 [St] Status: MEDLINE

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[PMID]: 27742158 [Au] Autor: Wierer G; Runer A; Gföller P; Fink C; Hoser C [Ad] Endereço: Department of Traumatology and Sports Injuries, Paracelsus Medical University Salzburg, Muellner Hauptstrasse 48, 5020 Salzburg, Austria; Gelenkpunkt - Center for Sports and Joint Surgery, Olympiastraße 39, 6020 Innsbruck, Austria. Electronic address: wierer@gmail.com. [Ti] Título: Extension deficit after anterior cruciate ligament reconstruction: Is arthroscopic posterior release a safe and effective procedure? [So] Source: Knee;24(1):49-54, 2017 Jan. [Is] ISSN: 1873-5800 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: BACKGROUND: Postoperative extension deficits following anterior cruciate ligament (ACL) reconstruction can cause major limitation during daily life. The purpose of this study was to evaluate the efficiency of an all-arthroscopic approach and posterior capsule release for the treatment of persistent knee extension deficits following ACL reconstruction. METHODS: Between 2009 and 2013 a total of 10 patients with knee flexion contractures after ACL reconstruction were assessed following an all-arthroscopic approach and posterior capsulotomy. The clinical outcomes were reviewed using the range of motion (ROM), Tegner Activity Level, Lysholm score and visual analogue pain scale (VAS). RESULTS: Four women and six men with a median age of 34years (range: 17 to 49years) were included in the study. The median follow-up period was 25months (range: 14 to 69months). The median preoperative extension deficit was 15° (range: 10 to 20°) compared to the normal contralateral knee. Postoperatively at final follow-up the median extension deficit was one degree (range: 0 to five degrees) (P<0.01). The median preoperative Lysholm score improved from 52 (range: 32 to 67) to 92 (range: 84 to 100) postoperatively (P<0.01), while the median Tegner Activity Level improved from three (range: two to six) to six (range: three to seven) respectively (P<0.02). The median VAS status for pain decreased from five (range: one to 10) to one (range: 0 to three) (P<0.01). No complications were observed. CONCLUSIONS: Arthroscopic posterior capsulotomy is a safe and effective additional procedure in the treatment of persistent knee extension deficits following ACL reconstruction with excellent results regarding ROM and subjective outcomes. LEVEL OF EVIDENCE: Level IV. [Mh] Termos MeSH primário: Reconstrução do Ligamento Cruzado Anterior/efeitos adversos Contratura/etiologia Contratura/cirurgia Liberação da Cápsula Articular [Mh] Termos MeSH secundário: Adolescente Adulto Lesões do Ligamento Cruzado Anterior/complicações Lesões do Ligamento Cruzado Anterior/cirurgia Estudos de Coortes Contratura/fisiopatologia Feminino Seres Humanos Escore de Lysholm para Joelho Masculino Meia-Idade Amplitude de Movimento Articular Resultado do Tratamento Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170926 [Lr] Data última revisão: 170926 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161016 [St] Status: MEDLINE

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[PMID]: 26214328 [Au] Autor: Jauregui JJ; Zamani S; Abawi HH; Herzenberg JE [Ad] Endereço: *Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore ‡Department of Orthopaedic Surgery, University of Maryland Medical System, Baltimore, MD †Department of Orthopaedic Surgery, Atieh Hospital, Tehran, Iran. [Ti] Título: Ankle Range of Motion After Posterior Subtalar and Ankle Capsulotomy for Relapsed Equinus in Idiopathic Clubfoot. [So] Source: J Pediatr Orthop;37(3):199-203, 2017 Apr/May. [Is] ISSN: 1539-2570 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: INTRODUCTION: Posterior capsulotomy can correct residual clubfoot deformity, but has been associated with ankle stiffness. The purpose of this study was to evaluate clinical ankle range of motion (ROM) following posterior capsulotomy immediately postsurgery and during long-term follow-up. METHODS: A retrospective clinical and radiographic review of 257 patients (398 feet) was performed to evaluate all patients who required a posterior capsulotomy as part of their clubfoot management. Twenty feet (16 patients) were identified with a mean age of 73.3±37.7 months and mean Pirani score of 5.2±0.8 points. Following capsulotomy, a long-leg cast was placed and maintained for a mean of 26 days (range, 21 to 35 d). At cast removal, parents were trained and instructed to immediately begin home physiotherapy. The capsulotomy cohort was age and sex matched to a cohort treated exclusively with the Ponseti method for comparison. Children in the comparison cohort had a mean Pirani score of 5.7±0.8 points. RESULTS: The mean dorsiflexion in the capsulotomy cohort significantly increased comparing the preoperative to the immediate postoperative ROM (from -6.5 to +9.7 degrees). No significant reduction in this gain was observed at latest follow-up (to +8.3 degrees). No significant difference in the plantar-flexion angle was found. Radiographically, a significant improvement in the lateral anterior tibial-calcaneal angle angles was found (P<0.05). CONCLUSIONS: If utilizing our protocol for early mobilization, limited use of capsulotomy to treat relapsed clubfoot does not necessarily reduce ankle ROM. Our protocol of placing the feet in casts for a shorter duration of time and providing early physiotherapy helps maintain ankle ROM after a posterior capsulotomy. LEVEL OF EVIDENCE: Level III-therapeutic study. [Mh] Termos MeSH primário: Articulação do Tornozelo/cirurgia Pé Torto Equinovaro/cirurgia Liberação da Cápsula Articular/métodos Amplitude de Movimento Articular/fisiologia [Mh] Termos MeSH secundário: Articulação do Tornozelo/fisiopatologia Moldes Cirúrgicos Criança Pré-Escolar Feminino Seres Humanos Lactente Masculino Modalidades de Fisioterapia Recidiva Estudos Retrospectivos Tendões/cirurgia Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170620 [Lr] Data última revisão: 170620 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 150728 [St] Status: MEDLINE [do] DOI: 10.1097/BPO.0000000000000611

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[PMID]: 27518297 [Au] Autor: Nunez FA; Papadonikolakis A; Li Z [Ad] Endereço: Wake Forest University Health Sciences Center, Division of Surgical Sciences, Department of Orthopaedic Surgery, Winston-Salem, North Carolina. fnunez@wakehealth.edu. [Ti] Título: Arthroscopic Release of Adhesive Capsulitis of the Shoulder Complicated With Shoulder Dislocation and Brachial Plexus Injury. [So] Source: J Surg Orthop Adv;25(2):114-6, 2016. [Is] ISSN: 1548-825X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: The incidence of brachial plexus injury after shoulder dislocation or arthroscopic shoulder surgery is low. Complex regional pain syndrome (CRPS) is an uncommon but painful condition that can develop after nerve injury. Historically, CRPS has been difficult to treat and therapeutic efforts are sometimes limited to ameliorating symptoms. However, if a dystrophic focus can be identified, the condition can be addressed with surgical exploration for potential neurolysis or nerve repair. The present article reports on a case of type II CRPS that developed in the postoperative setting of arthroscopic shoulder surgery complicated with simple shoulder dislocation. [Mh] Termos MeSH primário: Plexo Braquial/lesões Bursite/cirurgia Síndromes da Dor Regional Complexa/etiologia Liberação da Cápsula Articular/efeitos adversos Traumatismos dos Nervos Periféricos/etiologia Complicações Pós-Operatórias/etiologia Luxação do Ombro/etiologia Articulação do Ombro/cirurgia [Mh] Termos MeSH secundário: Artroscopia Feminino Seres Humanos Meia-Idade [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1701 [Cu] Atualização por classe: 170104 [Lr] Data última revisão: 170104 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160813 [St] Status: MEDLINE

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[PMID]: 27239889 [Au] Autor: van der Holst M; van der Wal CW; Wolterbeek R; Pondaag W; Vliet Vlieland TP; Nelissen RG [Ad] Endereço: Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, NL-2300 RC Leiden, The Netherlands. m.van_der_holst@lumc.nl. [Ti] Título: Outcome of secondary shoulder surgery in children with neonatal brachial plexus palsy with and without nerve surgery treatment history: A long-term follow-up study. [So] Source: J Rehabil Med;48(7):609-17, 2016 Jul 18. [Is] ISSN: 1651-2081 [Cp] País de publicação: Sweden [La] Idioma: eng [Ab] Resumo: OBJECTIVE: Irrespective of treatment history, shoulder dysfunction may occur in children with neonatal brachial plexus palsy. Following internal contracture release and/or muscle tendon transfer (ICR/MTT) shoulder function gain is possible. This study describes the outcomes of ICR/MTT for children with neonatal brachial plexus palsy, with or without prior nerve surgery (a group with prior nerve surgery and a group without prior nerve surgery). PATIENTS AND METHODS: The study included children who underwent an ICR/MTT with a minimum follow-up of 6 months. Active/passive range of motion (aROM/pROM)/Mallet scores were recorded (pre-operatively, 6 months, and 1, 3, 5 and 10 years post-surgery). Changes over time within groups were analysed using a linear mixed model. RESULTS: A total of 115 children (60 boys) were included, 82 with nerve surgery history, mean age 4.7 years (standard deviation (SD) 3.3 years), mean follow-up 6 years (SD 3.2 years). Pre-operatively active external rotation, abduction and forward-flexion were worse in the group with prior nerve surgery. aROM, pROM and Mallet scores, improved at all time-points in both groups. The course and magnitude of these improvements were largely similar in both groups. In the long-term, the effects of ICR/MTT decrease, but remain significant. CONCLUSION: In children with neonatal brachial plexus palsy shoulder function improved after ICR/MTT, irrespective of treatment history. Pre-operative shoulder function was worse in the group with prior nerve surgery, resulting in less function in this group after ICR/MTT. Reporting on outcome after secondary shoulder surgery should be stratified into children with and without prior nerve surgery, in order to prevent over- or underestimation of results. LEVEL OF EVIDENCE: This study concerned a retrospective treatment case series study. LEVEL OF EVIDENCE: IV. [Mh] Termos MeSH primário: Neuropatias do Plexo Braquial/cirurgia Liberação da Cápsula Articular/métodos Articulação do Ombro/cirurgia Transferência Tendinosa/métodos [Mh] Termos MeSH secundário: Neuropatias do Plexo Braquial/fisiopatologia Criança Pré-Escolar Feminino Seguimentos Seres Humanos Masculino Amplitude de Movimento Articular/fisiologia Reoperação Estudos Retrospectivos Articulação do Ombro/fisiopatologia Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1612 [Cu] Atualização por classe: 161230 [Lr] Data última revisão: 161230 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160531 [St] Status: MEDLINE [do] DOI: 10.2340/16501977-2193

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[PMID]: 27212048 [Au] Autor: Wuerz TH; Song SH; Grzybowski JS; Martin HD; Mather RC; Salata MJ; Espinoza Orías AA; Nho SJ [Ad] Endereço: Center for Hip Preservation, Division of Sports Medicine, New England Baptist Hospital, Boston, Massachusetts, U.S.A. [Ti] Título: Capsulotomy Size Affects Hip Joint Kinematic Stability. [So] Source: Arthroscopy;32(8):1571-80, 2016 Aug. [Is] ISSN: 1526-3231 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: To evaluate the effect of capsulotomy size and subsequent repair on the biomechanical stability of hip joint kinematics through external rotation of a cadaveric hip in neutral flexion. METHODS: Eight fresh-frozen cadaveric hip specimens were used in this study. Each hip was tested under torsional loads of 6 N·m applied by a servohydraulic frame and transmitted by a pulley system. The test conditions were (1) neutral flexion with the capsule intact, (2) neutral flexion with a 4-cm interportal capsulotomy, (3) neutral flexion with a 6-cm capsulotomy, and (4) neutral flexion with capsulotomy repair. Soft tissue was retained during all interventions. Measures indicating joint kinematics (range of motion [ROM], hysteresis area [HA], and neutral zone [NZ]) were obtained for each condition. RESULTS: For all hip specimens, the average ROM, HA, and NZ were calculated relative to the intact capsular state (100%) and expressed in terms of percentage (± SD). The findings for ROM were as follows: intact, 100%; 4 cm, 107.42% ± 5.69%; 6 cm, 113.40% ± 7.92%; and repair, 99.78% ± 3.77%. The findings for HA were as follows: intact, 100%; 4 cm, 108.30% ± 9.30%; 6 cm, 115.30% ± 13.92%; and repair, 99.47% ± 4.12%. The findings for NZ were as follows: intact, 100%; 4 cm, 139.61% ± 62.35%; 6 cm, 169.25% ± 78.19%; and repair, 132.03% ± 64.38%. Statistically significant differences in ROM existed between the intact and 4-cm conditions (P = .039), the intact and 6-cm conditions (P < .0001), the 4-cm and repair conditions (P = .033), and the 6-cm and repair conditions (P < .0001). There was no statistically significant difference between the intact and repair conditions (P > .99) or between the 4- and 6-cm conditions (P = .126). CONCLUSIONS: Under laboratory-based conditions, larger-sized capsulotomies were accompanied by increases in all 3 measures of joint mobility: ROM, HA, and NZ at time zero. Complete capsular closure effectively restored these measures when compared with the intact condition. CLINICAL RELEVANCE: Cadaveric models consisting of the hip joint with surrounding soft tissue were used under laboratory testing conditions to investigate potential iatrogenic joint instability resulting from expansive capsulotomies, showing that complete capsular closure leads to reconstitution of original joint stability properties at time zero. [Mh] Termos MeSH primário: Articulação do Quadril/cirurgia Liberação da Cápsula Articular Instabilidade Articular/fisiopatologia Complicações Pós-Operatórias/fisiopatologia Amplitude de Movimento Articular [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Fenômenos Biomecânicos Cadáver Feminino Articulação do Quadril/fisiopatologia Seres Humanos Masculino Meia-Idade Rotação [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171004 [Lr] Data última revisão: 171004 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160524 [St] Status: MEDLINE

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[PMID]: 27180923 [Au] Autor: Itoi E; Arce G; Bain GI; Diercks RL; Guttmann D; Imhoff AB; Mazzocca AD; Sugaya H; Yoo YS [Ad] Endereço: Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan. Electronic address: itoi-eiji@med.tohoku.ac.jp. [Ti] Título: Shoulder Stiffness: Current Concepts and Concerns. [So] Source: Arthroscopy;32(7):1402-14, 2016 Jul. [Is] ISSN: 1526-3231 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: UNLABELLED: Shoulder stiffness can be caused by various etiologies such as immobilization, trauma, or surgical interventions. The Upper Extremity Committee of ISAKOS defined the term "frozen shoulder" as idiopathic stiff shoulder, that is, without a known cause. Secondary stiff shoulder is a term that should be used to describe shoulder stiffness with a known cause. The pathophysiology of frozen shoulder is capsular fibrosis and inflammation with chondrogenesis, but the cause is still unknown. Conservative treatment is the primary choice. Pain control by oral medication, intra-articular injections with or without joint distension, and physical therapy are commonly used. In cases with refractory stiffness, manipulation under anesthesia or arthroscopic capsular release may be indicated. Because of various potential risks of complications with manipulations, arthroscopic capsular release is preferred. After the capsular release, stepwise rehabilitation is mandatory to achieve satisfactory outcome. LEVEL OF EVIDENCE: Level V, evidence-based review. [Mh] Termos MeSH primário: Bursite/terapia [Mh] Termos MeSH secundário: Anti-Inflamatórios não Esteroides/uso terapêutico Bursite/diagnóstico Bursite/etiologia Diagnóstico por Imagem Seres Humanos Injeções Intra-Articulares Liberação da Cápsula Articular Manipulação Ortopédica Exame Físico Modalidades de Fisioterapia Complicações Pós-Operatórias Terminologia como Assunto [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Anti-Inflammatory Agents, Non-Steroidal) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171019 [Lr] Data última revisão: 171019 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160517 [St] Status: MEDLINE

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