scholarly journals Can manipulation under anesthesia alone provide clinical outcomes similar to arthroscopic circumferential capsular release in primary frozen shoulder (FS)?: the necessity of arthroscopic capsular release in primary FS

2020 ◽  
Vol 23 (4) ◽  
pp. 169-177
Author(s):  
Seung-Jin Lee ◽  
Jun-Hyuk Jang ◽  
Yoon-Suk Hyun
Keyword(s):  
Clinical Outcomes ◽  
Frozen Shoulder ◽  
Manipulation Under Anesthesia ◽  
Steroid Injections ◽  
Treatment Groups ◽  
Capsular Release ◽  
Arthroscopic Capsular Release ◽  
Group A ◽  
Shoulder Motion ◽  
Group B

Background: We evaluated the need for arthroscopic capsular release (ACR) in refractory primary frozen shoulder (FS) by comparing clinical outcomes of patients treated with ACR and manipulation under anesthesia (MUA). Methods: We assessed patients with refractory primary FS, 54 patients (group A) who were treated with MUA and 22 patients (group B) who were treated with ACR. In group A, manipulation including a backside arm-curl maneuver was performed under interscalene brachial block. In group B, manipulation was performed only to release the inferior capsule before arthroscopic circumferential capsular release, which was carried out for the unreleased capsule after manipulation. Pain, range of shoulder motion, and American Shoulder and Elbow Society score were recorded at 1 week, 3 months, 6 months, and 1 year after surgery. We compared outcome variables between treatment groups and between diabetics and non-diabetics and also evaluated the numbers of patients receiving additional intra-articular steroid injection.Results: Outcome variables at 3 months after surgery and improvements in outcome variables did not differ between groups. Group A showed significantly better results than group B in the evaluation of pain and range of motion at 1 week. Diabetics showed comparable outcomes to non-diabetics for most variables. Eleven patients required additional steroid injections between 8 to 16 weeks after surgery: 12.2% in group A, 18.2% in group B. Additional injections were given three times more often in diabetics compared to non-diabetics.Conclusions: MUA alone can yield similar clinical outcomes to ACR in refractory FS.

scholarly journals Role of bicipital tenotomy in adhesive capsulitis

2020 ◽  
Author(s):  
Mohamed Aly
Keyword(s):  
Frozen Shoulder ◽  
Capsular Release ◽  
Biceps Tenotomy ◽  
Arthroscopic Capsular Release ◽  
Group A ◽  
The Mean ◽  
Long Head ◽  
Group B ◽  
Better Than

Purpose: To compare the results of arthroscopic capsular release of frozen shoulder with the tenotomy of the long head of biceps tendon versus capsular release without long head of biceps tenotomy. Methods: This is a prospective study that will include forty patients with resistant frozen shoulder presenting to El- Hadra University Hospital, Alexandria, Egypt. Arthroscopic release will be performed on twenty patients with biceps tenotomy (group A), while the other twenty patients will undergo arthroscopic release without biceps tenotomy (group B). Patients were evaluated preoperatively, at 2 week and 6 weeks postoperatively as regard Constant and Murley score. Results: In group (A), at the end of the follow up period, the mean score was (84.55 ± 19.32) ranging from 68.0 – 164.0 according to the Constant and Murly shoulder score. (table 5) . In group (B), at the end of the follow up period, the mean score was (79.55 ± 6.85) ranging from 68.0 – 94.0 according to the Constant and Murly shoulder score. . The difference between the means of postoperative total score in both groups was statistically insignificant (p = 0.718). Conclusion: Arthroscopic capsular release is an effective and safe method for treatment of refractory cases of frozen shoulder in which other treatment methods failed. Arthroscopic capsular release, achieves dramatic pain and motion improvement immediately postoperative, allowing very early postoperative rehabilitation. Circumferential capsular release is mandatory to achieve considerable range of shoulder motion in all directions. There are no significant differences between arthroscopic capsular release with biceps tenotomy and without biceps tenotomy regarding to final Constant and Murley score. Internal rotation is the slowest and most difficult motion to recover while gains in forward elevation are achieved the fastest.The improvement in range of external rotation is better than the improvement in the internal rotation. Diabetes mellitus is a bad prognostic risk factor, and the improvement in the range of motion in non-diabetic patients is better than the improvement in diabetic

scholarly journals A Comparative Study of Steroid Injection With or Without Lignocaine in Treating Frozen Shoulder

2018 ◽  
Vol 5 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Alok Pandey ◽  
B Shrestha ◽  
K M Shrestha
Keyword(s):  
Range Of Motion ◽  
Steroid Injection ◽  
Frozen Shoulder ◽  
Equal Frequency ◽  
Steroid Injections ◽  
Shoulder Range Of Motion ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Dominant Side

BACKGROUND: Treatment of Frozen shoulder (Adhesive Capsulitis) is mainly nonoperative. Intra-articular steroid injections and physiotherapy are one of the most effective and useful treatment. Even though intra-articular steroid injections are very effective in inflammatory phase of the disease; patients are reluctant to move their affected shoulder for fear of pain. Thus, they do not follow exercise program properly resulting in poor outcomes.OBJECTIVE: If pain could be reduced, outcome of treatment can improve. Lignocaine, when combined with steroid injection, plays an important role in immediate improvement of pain and active range of motion thereby increasing the overall result. MATERIALS & METHODS: 100 patients with frozen shoulder were selected according to predetermined inclusion and exclusion criteria. After randomization by sealed envelope technique, patients were divided into Group A and Group B. Group A patients were injected with 2 ml (80 mg) of methylprednisolone and 3 ml of 1% Lignocaine, and Group B patients were injected with 2 ml (80 mg) of methylprednisolone and 3 ml of Distilled water in the affected shoulder via standard posterior approach. Then half an hour of standard shoulder range of motion (ROM) exercise regimen was performed under supervision. Pre injection and post injection pain level was scored by Visual Analogue Score (VAS) and Subjective satisfaction score (SSS). Shoulder exercises were taught and home based physiotherapy was carried out by patients themselves. They were also prescribed oral analgesics for 5 days and were followed at 1, 3, and 6 weeks. At every follow up visit, they were assessed for improvement via Constant-Murley Score (CMS).RESULTS: The mean age of this study in group A and group B was 56.46 years (SD 10.05) and 57.18 years (SD 8.87) respectively (P0.70). There were 31 male and 19 female in group A as compared to group B where there was 26 males and 24 females (P0.41). In both the groups, maximum number of patients presented at around 10 weeks. In both the groups left side dominated right side with equal frequency (33 left sides and 17 right sides) (P 1.00) and non dominant side outnumbered dominant side with near equal frequency (P 1.00). After the intervention, excellent result in SSS was observed only in group A whereas maximum patients of Group B had only fair result (42 patients). There was statistically significant difference between two groups in terms of pain; Activity of daily living (ADL) and Range of motion (ROM). Patients in group A were able to carry more weight than group B.   In CMS 1 and 6 week total, there was statistically highly significant difference between two groups. CONCLUSION: Even though steroid and physical exercises play important role in managing frozen shoulder, addition of lignocaine to steroid injection seems to be helpful. It relieves immediate pain on movement and improves exercise compliance thereby improving early outcomes. Evaluation of long term benefits of lignocaine injection needs further studies. Journal of Universal College of Medical Sciences (2017) Vol.05 No.01 Issue 15, Page: 22-28 

scholarly journals COMPARATIVE STUDY ON THE EFFICACY OF MAITLAND TECHNIQUE (GRADE IV) AND MULLIGAN TECHNIQUE, IN THE TREATMENT OF FROZEN SHOULDER

2013 ◽  
Vol 2 (1) ◽  
pp. 10-14
Author(s):  
Syed Abid Mehdi Kazmi ◽  
Jharna Devi ◽  
Faisal Yamin ◽  
Sunil Kumar
Keyword(s):  
Experimental Study ◽  
Functional Activity ◽  
Frozen Shoulder ◽  
Group Interventions ◽  
Treatment Results ◽  
Treatment Groups ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Positive Results

OBJECTIVES To compare the effectiveness of Maitland technique (Grade IV) and Mulligan technique for the treatment of frozen shoulders. STUDY DESIGN Experimental Study. STUDY SETTINGS & PARTICIPANTS This study has been conducted at Ziauddin Hospital with 50 volunteers who participated in the study that were equally divided into two groups (pre and post treatment groups). Subjects were randomly assigned to each group. INTERVENTIONS Intervention given to Group A was Maitland Technique (Grade IV) and Group B, Mulligan Technique. OUTCOME MEASURES Functional activity of shoulder is measured by using Shoulder Pain and Disability Index (SPADI) score, Pain is measured by VAS Score, and Range of motion, measured by Goniometer both before and after treatment. RESULTS Both the treatments showed positive results but Mulligan technique was found to be more effective. The total SPADI score was 15.48 before and 11.92 after the Mulligan technique and 15.32 before and 13.16 after the Maitland technique. CONCLUSIONS It is evident that Mulligan technique is more effective for the treatment of frozen shoulder compared to Maitland technique.

Evaluation of Arthroscopic Capsular Release Together with Manipulation Under Anesthesia for Treatment of Frozen Shoulder

2011 ◽  
Vol 31 (2) ◽  
pp. 397-404
Author(s):  
Mustafa ÖZKAN ◽  
Banu DİLEK ◽  
Figen KOÇYİĞİT ◽  
Selmin GÜLBAHAR ◽  
A. Kadir BACAKOĞLU
Keyword(s):  
Frozen Shoulder ◽  
Manipulation Under Anesthesia ◽  
Capsular Release ◽  
Arthroscopic Capsular Release

Comparative Study of effectiveness of mobilization with movement (MWM) and End range mobilization (ERM) techniques in frozen shoulder

2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Type I ◽  
Mean Values ◽  
Functional Activities ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.

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