Frozen shoulder | ||||
| The Egyptian Orthopaedic Journal | ||||
| Volume 47, Issue 3, September 2012, Page 260-264 PDF (439.05 K) | ||||
| DOI: 10.7123/01.EOJ.0000417994.63939.80 | ||||
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| Author | ||||
| Mohamed M. Abdel-Hamid | ||||
| Abstract | ||||
| Background Frozen shoulder is a common problem in middle-aged men and women, especially in diabetic patients. It is characterized by the gradual development of overall limitation in active and passive shoulder motion. If conservative treatment, local injection, and physiotherapy have failed with these patients, arthroscopic capsular release or manipulation under general anesthesia (MUA), or both is indicated. In this work, the difference between performing arthroscopic release after MUA and manipulation alone is studied. Patients and methods A randomized prospective controlled study enrolled 43 consecutive patients who were diagnosed as having a frozen shoulder. There were 25 right shoulders and 18 left shoulders, treated in 29 women and 14 men. The mean age of the patients at the time of surgery was 51 years (range 40–62 years). The patients were divided randomly into two groups. The first group included 21 patients in whom arthroscopy was carried out after MUA. The second group included 22 patients in whom MUA only was carried out and served as a control group. The shoulder range of motion (ROM) values were recorded before and after the procedure, as well as the constant score. The mean follow-up period was 16 months for the patients (range 12–20 months). Results Statistically, there was no difference in the demographic data between the two groups. In the first group in which arthroscopy was used, three patients (14.3%) were unsatisfied because of the persistence of pain and recurrence of symptoms and 18 patients (85.7%) were satisfied overall in terms of pain and improvement in ROM. In the second group, four patients (18.2%) were unsatisfied and 18 patients (81.8%) were satisfied after the procedure. In group 1, the mean preoperative constant score was 15±4, which improved significantly to 70±21 (<0.001) in the last follow-up. In group 2, the mean preoperative constant score was 15±3.7. This improved significantly to 64±20 (<0.001) in the last follow-up. There was no significant difference in the postoperative constant score groups (=0.3). There were also no significant difference in abduction (=0.9), flexion (=0.8), or external rotation (=0.5) between the two groups. Conclusion At the last follow-up, the percentage of recurrence was slightly higher in the second group, who had only MUA, but there was no statistical difference between both the groups in terms of pain, ROM, and constant score. However, arthroscopy may lead to more technical difficulty and more risk of longer anesthesia time. | ||||
| Keywords | ||||
| Arthroscopy; Frozen shoulder; manipulation under anesthesia | ||||
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