From the Research
The treatment for an acute capsular avulsion injury should prioritize arthroscopic all-inside menisco-capsular repair, as it has been shown to be effective in improving outcomes and reducing complications, as demonstrated in a study published in the International Orthopaedics journal 1. The goal of treatment is to restore the normal anatomical position of the avulsed capsule, prevent further injury, and maintain joint stability.
- The initial management involves a combination of rest, ice, compression, and elevation (RICE protocol) for the first 24-48 hours to reduce pain and swelling.
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (400-600mg three times daily) or naproxen (500mg twice daily) can help manage pain and inflammation for 5-7 days.
- Physical therapy should begin after the acute phase, focusing on gentle range of motion exercises progressing to strengthening exercises over 4-6 weeks.
- For severe avulsions with significant displacement, surgical intervention may be necessary to reattach the capsule to bone using suture anchors or screws, as supported by a study published in the British Journal of Sports Medicine 2.
- A period of immobilization with a brace or splint for 1-3 weeks is often recommended post-injury or post-surgery, followed by gradual return to activities as pain and function improve. The effectiveness of arthroscopic capsular release in patients with primary and secondary adhesive shoulder capsulitis has also been demonstrated, with significant improvements in pain and range of motion, as shown in a study published in the Knee Surgery, Sports Traumatology, Arthroscopy journal 3. However, the most recent and highest quality study on the topic of acute capsular avulsion injury is the one published in the International Orthopaedics journal 1, which supports the use of arthroscopic all-inside menisco-capsular repair. It's worth noting that the use of corticosteroid injections for adhesive capsulitis has been shown to be effective in reducing pain and improving range of motion, but the evidence is not directly applicable to acute capsular avulsion injuries, as demonstrated in a study published in the Medicine journal 4. In contrast, a study published in the Arthroscopy Techniques journal 5 discusses the technique of arthroscopic 360° capsular release for adhesive capsulitis, but it is not directly relevant to the treatment of acute capsular avulsion injuries.