Resultados de la Artrolisis Artroscópica Seguida de un Programa de Rehabilitación Precoz Ambulatoria con Catéter Interescalénico Permanente como Tratamiento de la Rigidez Secundaria de Hombro

Abstract

Objective: To evaluate outcomes of arthroscopic arthrolysis followed by an early rehabilitation protocol using an indwelling interscalene catheter as treatment of secondary shoulder stiffness.
Materials and methods: A retrospective review of cases who had surgery for shoulder stiffness with an identifiable cause is performed. An interscalene catheter is left after surgery for nervous blockade for at least 5 days. Hospital check-out is carried out immediately after first physical therapy session, at 24 hours from surgery. Outcomes are presented as improvement of range of motion, pain and functional status.
Results: 11 patients were included in the study. Causes of stiffness were previous surgeries consisting on osteosynthesis for proximal humeral fractures, repair of rotator cuff tears, Bankart repair and trauma without fracture. Mean follow-up was 26.4 (8.3) months. Significant differences on flexion [95.6 (32)º - 153.4 (59)º], external rotation [33.9 (17)º - 59.2 (32)º], VAS [7.2 (2.9) - 2.1 (1.7)] and Quick-DASH Score [68.2 (33)º - 22.7 (13)º] were observed, while no differences on internal rotation and ASES Score. No complications were registered. One case required re-operation at 3 months due to no progression of shoulder motion. Cause of stiffness did not influence outcomes.
Conclusion: Arthroscopic arthrolysis followed by early rehabilitation with nervous blockade of the extremity by an indwelling interscalene catheter is safe and provides good functional outcomes.

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