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
| Autor: | Yoon-Suk Hyun, Jun-Hyuk Jang, Seung-Jin Lee |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Geography Planning and Development Elbow Management Monitoring Policy and Law Group B 03 medical and health sciences 0302 clinical medicine lcsh:Orthopedic surgery Refractory Capsular release Diabetes mellitus Medicine Manipulation 030222 orthopedics business.industry Diabetes Capsule Frozen shoulder 030229 sport sciences medicine.disease Surgery lcsh:RD701-811 medicine.anatomical_structure Original Article business Range of motion Manipulation under anesthesia |
| Zdroj: | Clinics in Shoulder and Elbow Clinics in Shoulder and Elbow, Vol 23, Iss 4, Pp 169-177 (2020) |
| ISSN: | 2288-8721 2383-8337 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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