Diabetic and non-diabetic patients report equal symptom relief after arthroscopic capsular release of frozen shoulder

Abstract

Background: Frozen shoulder is a painful joint disease. Patients with diabetes seem to have worse clinical symptoms and surgery in this patient population is believed to be more common. The objective postoperative evaluation indicates inferior results when surgically treating diabetics, but no previous studies have investigated exclusively the subjective patient satisfaction with arthroscopic capsular release. Materials and methods: A total of 93 patients were included. All had persistent symptoms despite conservative treatment for at least six months. The patients were retrospectively divided into two groups based on diabetes status: Group 1 consisted of patients with type 1 or type 2 diabetes (18) and group 2 consisted of the remaining patients (75). Evaluation was performed prior to arthroscopic capsular release and at six months follow-up. The web-based questionnaire consisted of two different evaluation forms: The Oxford Shoulder Score (OSS) and a visual quality scale (VQS). Results: Both groups reported a statistically significant improvement in both evaluations. OSS in group 1 improved by 11.5 [95% CI: 6.2 ; 16.4] and by 15.8 [95% CI: 13.6 ; 17.9] in group 2. The improvement was more pronounced in group 2, though not statistically significant (p = 0.09). The VQS improved 39.6 in group 1 and 44.5 in group 2, (p = 0.50). Conclusion: Diabetic and non-diabetic patients reported equal symptom relief after arthroscopic capsular release of frozen shoulder when selected for operation without considering diabetic status. We will continue to select patients for arthroscopic release without differences in preoperative counseling between diabetics and non-diabetics.

Outcome After Arthroscopic Capsular Release for Refractory Idiopathic Frozen Shoulder between Diabetic and Non-Diabetic Patients

“…There was no significant difference in preoperative Oxford shoulder score and postoperative Oxford shoulder score between the diabetic and the non-diabetic patients. Some studies also showed no significant difference in OSS between the diabetic and the nondiabetic patients (18,33,34,35) .…”

Arthroscopic rotator interval release for frozen shoulder, comparative study between diabetic and non-diabetic patients

“…Our results are similar to previous studies ( Table 4 ) that compared the results of arthroscopic capsular release in diabetic and non-diabetic patients. Lyhne et al [ 19 ], although they performed anterior and posterior capsular release. They concluded that all patients, whether diabetic or non-diabetic, equally improved after arthroscopic capsular release when operated on regardless of diabetic status.…”

“…of patients Avg. age (years) Follow up Surgical technique Functional score Results Encountered complications Lyhne JM et al (2019) [ 19 ] 18 diabetic 75 non-diabetic Diabetic: 55.2 non-diabetic: 56 6 months Arthroscopic capsular release (360° arthroscopic capsulotomy). -Oxford Shoulder Score (OSS).…”

Comparison of Clinical Outcomes between Idiopathic Frozen Shoulder and Diabetic Frozen Shoulder After a Single Ultrasound-Guided Intra-Articular Corticosteroid Injection

“…However, there have been few well-designed studies of natural history of diabetic FS and comparison of clinical outcomes between diabetic FS and idiopathic FS after conservative treatments [ 14 , 24 ]. Also, the concept of resistance to treatment in diabetic FS has been mainly based on the results of studies about arthroscopic capsular release or manipulation under anesthesia [ 10 , 16 , 18 , 20 , 25 , 26 , 27 , 28 ]. Rill et al reported that patients with diabetes had a lower final Simple Shoulder Test score than patients without diabetes after non-operative treatments which were heterogeneous to each patient, but diabetes did not predict the need for surgery [ 29 ].…”

“…It has been widely-accepted by some experts that the treatment of diabetic patients with FS compared to that of idiopathic FS is more difficult and they show more resistance to treatment [15][16][17][18][19][20][21][22][23]. However, there have been few well-designed studies of natural history of diabetic FS and comparison of clinical outcomes between diabetic FS and idiopathic FS after conservative treatments [14,24].…”