Manipulation under anaesthesia with local intracapsular steroid injection in treatment of frozen shoulder
Abstract
Aims and Objective: Adhesive capsulitis of shoulder (frozen shoulder) is a condition characterized by pain, stiffness and restriction of movement of shoulder joint. The present study was carried out to assess the role of manipulation under anaesthesia along with intracapsular steroid injection in treatment of frozen shoulder.
Material and Methods: The present study is a prospective study carried out in the department of Orthopedics, Ananta Institute of Medical Sciences, Rajsamand, Rajasthan during the period of 6 months from October 2018 to March 2019. 30 patients of unilateral idiopathic adhesive capsulitis (Frozen shoulder) who were symptomatic and not responding to physiotherapy were included in the study. All the patients underwent manipulation under anaesthesia and then intracapsular steroid injection was given via posterior approach. Patients were followed up regularly and reassessment using VAS (Visual analogue scale) scale and PROM (Passive Range of Motion) was done at 3 months after the procedure.
Results: Out of 30 patients included in the study, 18 (60%) were female and 12 (40%) were male. The age of the patients ranges from 20 years to 70 years with the mean age of 46.81 years. Non dominating hand was involved in 23 cases (76.66%). VAS score and degree of PROM were measured before and 3 months after the treatment.
Conclusion: In present study, VAS score as well as PROM were significantly improved 3 months after the treatment of frozen shoulder with manipulation under anaesthesia along with intracapsular steroid injection. So, this treatment modality can be used as a safe and effective method to reduce pain and stiffness in frozen shoulder.
Downloads
References
2. Grey RG. The natural history of "idiopathic" frozen shoulder. J Bone Joint Surg Am. 1978 Jun;60(4):564.[pubmed]
3. Reeves B. The natural history of the frozen shoulder syndrome. Scand J Rheumatol. 1975;4(4):193-6.[pubmed]
4. Redler LH, Dennis ER. Treatment of Adhesive Capsulitis of the Shoulder. J Am AcadOrthop Surg. 2019 Jun 15;27(12):e544-e554. doi: 10.5435/JAAOS-D-17-00606.[pubmed]
5. Itoi E, Arce G, Bain GI, et al. Shoulder Stiffness: Current Concepts and Concerns. Arthroscopy. 2016 Jul;32(7):1402-14. doi: 10.1016/j.arthro.2016.03.024. Epub 2016 May 12.[pubmed]
6. Bunker TD, Anthony PP. The pathology of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br. 1995 Sep;77(5):677-83.[pubmed]
7. Neviaser AS, Neviaser RJ. Adhesive capsulitis of the shoulder. J Am AcadOrthop Surg. 2011 Sep;19(9):536-42.[pubmed]
8. Georgiannos D, Markopoulos G, Devetzi E, et al. Adhesive Capsulitis of the Shoulder. Is there Consensus Regarding the Treatment? A Comprehensive Review. Open Orthop J. 2017 Feb 28;11:65-76. doi: 10.2174/1874325001711010065. eCollection 2017.[pubmed]
9. Dodenhoff RM, Levy O, Wilson A, et al. Manipulation under anesthesia for primary frozen shoulder: effect on early recovery and return to activity. J Shoulder Elbow Surg. 2000 Jan-Feb;9(1):23-6.[pubmed]
10. Hill JJ Jr, Bogumill H. Manipulation in the treatment of frozen shoulder. Orthopedics. 1988 Sep;11(9):1255-60.[pubmed]
11. Janda DH, Hawkins RJ. Shoulder manipulation in patients with adhesive capsulitis and diabetes mellitus: A clinical note. J Shoulder Elbow Surg. 1993 Jan;2(1):36-8. doi: 10.1016/S1058-2746(09)80135-3. Epub 2009 Feb 19.[pubmed]
12. Kivimäki J, Pohjolainen T. Manipulation under anesthesia for frozen shoulder with and without steroid injection. Arch Phys Med Rehabil. 2001 Sep;82(9):1188-90.
13. Othman A, Taylor G. Manipulation under anaesthesia for frozen shoulder. Int Orthop. 2002;26(5):268-70. Epub 2002 Mar 27. DOI:10.1007/s00264-002-0348-2.[pubmed]
14. Hartrick CT, Kovan JP, Shapiro S. The numeric rating scale for clinical pain measurement: a ratio measure? Pain Pract. 2003 Dec;3(4):310-6. DOI:10.1111/j.1530-7085.2003.03034.x.[pubmed]
15. van Royen BJ, Pavlov PW. Treatment of frozen shoulder by distension and manipulation under local anaesthesia. Int Orthop. 1996;20(4):207-10. DOI:10.1007/s002640050064.
16. Hamdan TA, Al-Essa KA. Manipulation under anaesthesia for the treatment of frozen shoulder. Int Orthop. 2003;27(2):107-9. Epub 2002 Sep 13. DOI:10.1007/s00264-002-0397-6.[pubmed]
17. Ahmad I, Askar Z, Durrani Z, et al. Intraarticular injection of methylprednisolone for idiopathic frozen shoulder. J Med Sci. 2009; 17(1):16–18.
18. Arslan S, Celiker R. Comparison of the efficacy of local corticosteroid injection and physical therapy for the treatment of adhesive capsulitis. Rheumatol Int. 2001 Sep;21(1):20-3.[pubmed]
19. Carette S, Moffet H, Tardif J, et al. Intraarticular corticosteroids, supervised physiotherapy, or a combination of the two in the treatment of adhesive capsulitis of the shoulder: a placebo-controlled trial. Arthritis Rheum. 2003 Mar;48(3):829-38. DOI:10.1002/art.10954.[pubmed]
20. Ryans I, Montgomery A, Galway R, et al. A randomized controlled trial of intra-articular triamcinolone and/or physiotherapy in shoulder capsulitis. Rheumatology (Oxford). 2005 Apr;44(4):529-35. Epub 2005 Jan 18. DOI:10.1093/rheumatology/keh535.[pubmed]
21. de Jong BA, Dahmen R, Hogeweg JA, et al. Intra-articular triamcinolone acetonide injection in patients with capsulitis of the shoulder: a comparative study of two dose regimens. Clin Rehabil. 1998 Jun;12(3):211-5.[pubmed]
22. Rizk TE, Pinals RS, Talaiver AS. Corticosteroid injections in adhesive capsulitis: investigation of their value and site. Arch Phys Med Rehabil. 1991 Jan;72(1):20-2.[pubmed]
23. Lee HJ, Lim KB, Kim DY, et al. Randomized controlled trial for efficacy of intra-articular injection for adhesive capsulitis: ultrasonography-guided versus blind technique. Arch Phys Med Rehabil. 2009 Dec;90(12):1997-2002. doi: 10.1016/j.apmr.2009.07.025.[pubmed]
24. Jacobs LG, Smith MG, Khan SA, et al. Manipulation or intra-articular steroids in the management of adhesive capsulitis of the shoulder? A prospective randomized trial. J Shoulder Elbow Surg. 2009 May-Jun;18(3):348-53. doi: 10.1016/j.jse.2009.02.002.[pubmed]
OAI - Open Archives Initiative
Therapoid
