Sage Journals: Discover world-class research

Abstract

Background

We performed a prospective randomised trial recruiting patients with adhesive capsulitis of the shoulder, to undergo either manipulation under anaesthesia (MUA) or capsular distension.

Methods

Between 2006 and 2010, 28 patients (30 shoulders) were recruited. The mean age was 53 years (44–69). Randomisation was done using a sealed envelope.

Results

Preoperatively, the MUA group had significantly less mean abduction than the distension group (58.2 ± 5.2° vs. 75.7 ± 5.4°; p = 0.03). At 6 months, the MUA group achieved greater mean abduction (163.0 ± 2.4° vs. 130.7 ± 10.3°; p = 0.02). Preoperatively, the MUA group had significantly less external rotation compared to the distension group (11.0 ± 2.8° vs. 24.0 ± 4.1°; p = 0.03). At 6 months, the external rotation was not statistically different between the groups (40.3 ± 4.0° vs. 40.3 ± 4.6°; p = 0.75). Preoperatively, both groups had similar pain visual analogue score (VAS) (5.7 ± 0.6 vs. 4.7 ± 0.6; p = 0.30) and Disabilities of the Arm, Shoulder and Hand (DASH) scores (49.4 ± 4.7 vs. 53.8 ± 1.6; p = 0.26). However there was no statistically significant difference noted between the groups for VAS (1.5 ± 0.4 vs. 2.9 ± 0.8; p = 0.39) or DASH (12.4 ± 4.3 vs. 25.1 ± 6.4;p = 0.21) at 6-month review.

Discussion

MUA resulted in better shoulder abduction than capsular distension at 6 months following the procedure. However, there was no significant difference between the two groups in external rotation or pain relief achieved.

Keywords

Adhesive capsulitis frozen shoulder manipulation under anaesthesia capsular distension prospective randomized trial

Get full access to this article

View all access options for this article.

References

Bunker

. Time for a new name for frozen shoulder – contracture of the shoulder. Shoulder Elbow 2009; 1: 4–9.

Lundberg

. The frozen shoulder. Clinical and radiographical observations. The effect of manipulation under general anesthesia. Structure and glycosaminoglycan content of the joint capsule. Local bone metabolism. Acta Orthop Scand Suppl 1969; 119: 1–59.

Reeves

. The natural history of the frozen shoulder syndrome. Scand J Rheumatol 1975; 4: 193–6.

Grey

. The natural history of ‘idiopathic’ frozen shoulder. J Bone Joint Surg Am 1978; 60: 564.

Simmonds

. Shoulder pain with particular reference to the ‘frozen’ shoulder. J Bone Joint Surg Br 1949; 31B: 426–32.

Shaffer

, Tibone

, Kerlan

. Frozen shoulder. A long-term follow-up. J Bone Joint Surg Am 1992; 74: 738–46.

Buchbinder

RGS

, Youd

, Johnston

. Oral steroids for adhesive capsulitis. Cochrane Database Syst Rev 2006; (4): Art. No.: CD006189. DOI:10.1002/14651858.CD006189.

Buchbinder

RGS

, Youd

. Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev 2003; (1): Art. No.: CD004016. DOI:10.1002/14651858.CD004016.

Green

SBR

, Hetrick

. Physiotherapy interventions for shoulder pain. Cochrane Database Syst Rev 2003; (2): Art. No.: CD004258. DOI:10.1002/14651858.CD004258.

10.

Othman

, Taylor

. Manipulation under anaesthesia for frozen shoulder. Int Orthop 2002; 26: 268–70.

11.

Farrell

, Sperling

, Cofield

. Manipulation for frozen shoulder: long-term results. J Shoulder Elbow Surg 2005; 14: 480–4.

12.

, Amin

, Narborough

,. Manipulation under anaesthesia and early physiotherapy facilitate recovery of patients with frozen shoulder syndrome. Scott Med J 2009; 54: 29–31.

13.

Loew

, Heichel

, Lehner

. Intraarticular lesions in primary frozen shoulder after manipulation under general anesthesia. J Shoulder Elbow Surg 2005; 14: 16–21.

14.

Warner

, Allen

, Marks

,. Arthroscopic release for chronic, refractory adhesive capsulitis of the shoulder. J Bone Joint Surg Am 1996; 78: 1808–16.

15.

Ogilvie-Harris

, Myerthall

. The diabetic frozen shoulder: arthroscopic release. Arthroscopy 1997; 13: 1–8.

16.

Fareed

, Gallivan

Jr . Office management of frozen shoulder syndrome. Treatment with hydraulic distension under local anesthesia. Clin Orthop Relat Res 1989; 177–83.

17.

Sharma

, Bajekal

, Bhan

. Frozen shoulder syndrome. A comparison of hydraulic distension and manipulation. Int Orthop 1993; 17: 275–8.

18.

Hudak PL, Amadio PC, Bombardier C, The Upper Extremity Collaborative Group (UECG). Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. Am J Ind Med 1996; 29: 602–8.

19.

Quraishi

, Johnston

, Bayer

,. Thawing the frozen shoulder. A randomised trial comparing manipulation under anaesthesia with hydrodilatation. J Bone Joint Surg Br 2007; 89: 1197–200.

20.

Jacobs

, Smith

, Khan

,. Manipulation or intra-articular steroids in the management of adhesive capsulitis of the shoulder? A prospective randomized trial. J Shoulder Elbow Surg 2009; 18: 348–53.

A Prospective Randomized Trial Comparing Manipulation under Anaesthesia and Capsular Distension for the Treatment of Adhesive Capsulitis of the Shoulder