Comparison of Therapeutic Efficacy Between Arthroscopic Capsular Release and Transarterial Musculoskeletal Embolization in Patients with Adhesive Capsulitis of the Shoulder.

Abstract

Adhesive capsulitis is a debilitating shoulder disorder characterized by pain and restricted motion. While arthroscopic capsular release is a well-established surgical treatment, transarterial musculoskeletal embolization (TAME) has recently emerged as a minimally invasive alternative. The aim of this study is to compare the short-term clinical outcomes of arthroscopic capsular release and TAME in patients with adhesive capsulitis of the shoulder. We retrospectively analyzed 40 patients with refractory adhesive capsulitis who underwent either arthroscopic capsular release (n=19) or TAME (n=21) between August 2021 and August 2024. Pain severity (numeric rating scale, NRS), range of motion (ROM), and Constant-Murley scores were assessed at baseline and at 3 and 6 months post-procedure. The minimal clinically important difference (MCID) was calculated to evaluate meaningful clinical improvement. Both groups demonstrated significant improvement in pain, ROM, and Constant-Murley scores at 3 and 6 months compared with baseline. At 3 months, the TAME group showed significantly lower NRS scores (2.6 vs. 4.7, p < 0.001) and higher rates of MCID achievement in pain, anterior forward elevation, and Constant-Murley score. However, by 6 months, no significant differences were observed in any outcome measures between groups. Both arthroscopic capsular release and TAME were associated with meaningful improvements in pain, ROM, and function in patients with adhesive capsulitis. In this cohort, TAME may be associated with earlier pain relief and earlier attainment of clinically meaningful improvements.