Protocol for Ultrasound-Guided Posterior Glenohumeral Joint Capsule Acupotomy Procedure in Adhesive Capsulitis

Background: Adhesive Capsulitis (Frozen Shoulder) is characterized by pain and limited range of motion (ROM) in the shoulder, often caused by fibrosis and adhesions in the articular capsule.Ultrasound-guided interventions, particularly acupotomy, offer a minimally invasive approach to managing these conditions by targeting specific anatomical structures under visualization.Objectives: This study aimed to develop a standardized protocol for ultrasound-guided posterior shoulder capsule acupotomy in patients with adhesive capsulitis, focusing on precise localization and safe execution.Methods: The protocol involved identifying key anatomical structures such as the Axillary Pouch, Posterior Glenohumeral Joint Capsule, and Superior Glenohumeral Joint Capsule using ultrasound.Patients with ROM limitations were categorized based on their movement restrictions, and acupotomy was performed under ultrasound guidance at specific target sites.Key safety measures, including avoiding nerves and vessels, were integrated.Results: The protocol demonstrated effective localization of target structures and improved ROM in patients with adhesive capsulitis.No complications such as vascular or neural injury were observed.The use of ultrasound enhanced procedural precision and safety.Conclusion: Ultrasound-guided acupotomy provides a reliable and safe method for treating Adhesive Capsulitis, particularly during the frozen phase.By offering clear visualization and accurate targeting, this protocol enhances the efficacy and safety of interventions, addressing limitations of traditional techniques.Further research is needed to validate this protocol across diverse patient populations.