Arthroscopic capsular release versus manipulation under anaesthesia for treating frozen shoulder — a prospective randomised study

Clinical outcomes and cost-effectiveness of manipulation under brachial plexus block versus physiotherapy for refractory frozen shoulder: a prospective observational study

“… 22 Furthermore, another prospective randomized study that compared the cost-effectiveness between ACR and MUA also concluded that MUA was more cost-effective than ACR. 30 In the treatment of refractory FS, there is the possibility that MUB will contribute to the reduction of national health care costs.…”

“…Many studies regarding MUA have reported that the treatment, as a relatively simple procedure, has the potential to rapidly reduce symptoms and restore the range of motion (ROM) for refractory FS. 6 , 8 , 13 , 30 , 32 A multicenter and randomized control study in which ACR and MUA were compared with early structured PT revealed that none of the three interventions were clinically superior after 12 months; ACR carried a higher risk; and MUA was the most cost-effective. 22 However, other studies reported that MUA had no advantage when compared with conservative treatment, documenting the potential complications associated with this procedure such as dislocation, fractures, brachial plexus injury, bone bruise, labral detachment, and rotator cuff tears.…”

“…MUA was commonly performed under general anesthesia, and an ultrasound-guided cervical nerve root or brachial plexus block (MUB) has become a recent trend for shoulder manipulation in the outpatient setting. 1 , 6 , 8 , 13 , 15 , 25 , 30 , 32 This anesthesia method makes it convenient for the physician to change the patient’s position and facilitate the manipulation procedure without general anesthesia tools and hospitalization. Both MUA and PT appear to be effective treatments in patients with refractory FS, although it is unclear whether there are differences in the clinical outcomes and cost-effectiveness between the two treatment options.…”

Improved PROMs and Less Post-op Pain at 6 months with ACR and MUA compared to MUA Alone in Patients with Resistant Frozen Shoulder

“…Both of these techniques provide effective options for improving ROM and functional outcomes, leading to an improved quality of life. [4][5][6] MUA has been considered equally effective as other nonsurgical methods (intraarticular injection, physiotherapy) and surgical procedures such as ACR in the treatment of frozen shoulder. [7][8][9] It is a quick and cost-effective procedure with rapid results, such as pain reduction within 1 week of manipulation.…”

“…In contrast, ACR offers improved visualization inside the glenohumeral joint and enables the release of adhesions under arthroscopic guidance. 5,6 However, there is limited literature comparing the outcomes of ACR plus MUA versus MUA alone. Sivardeen et al reported that ACR plus MUA had significantly better functional outcomes when compared to MUA for short-term (less than 12 months) follow up.…”