Short-term clinical results of frozen shoulder treated with shoulder manipulation under ultrasound-guided cervical nerve root block at outpatient setting: A case series

Saito, Tomohiro; Sasanuma, Hideyuki; Iijima, Yuki; Kanaya, Yuji; Saito, Toshihiro; Watanabe, Hideaki; Kikkawa, Ichiro; Takeshita, Katsushi

doi:10.1016/j.jos.2016.11.007

Cited by 25 publications

(37 citation statements)

References 9 publications

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“…Recent studies have reported success with MUC for idiopathic frozen shoulder [17,18]. In a series of reports by Saito et al [17], the adjusted ASES score at one-year follow-up was, on average, 93 ± 9 points, which was similar to our results. On the other hand, in our study, 11 of 42 shoulders (26%) developed recurrent moderate pain and limited range of motion after the procedure.…”

Section: Discussionsupporting

confidence: 90%

The results of repeat manipulation under ultrasound-guided cervical nerve block (MUC) for recurrence of frozen shoulder.

Oshiro¹,

Yagi²,

Harada³

et al. 2020

Preprint

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Background This study aimed to evaluate the clinical results of a repeat manipulation under ultrasound-guided cervical nerve root block (MUC) for recurrence of idiopathic frozen shoulder after MUC. Methods A consecutive series of 42 shoulders in 39 patients with idiopathic frozen shoulder underwent MUC. All patients were assessed according to the American Shoulder Elbow Surgeon (ASES) score and shoulder range of motion (ROM) both before MUC and at one-year thereafter. If patients continued to have pain and limited ROM at 3 months after the procedure, they were offered a repeat MUC. Such patients were also assessed before the procedure and at 3 months and one-year thereafter. Results The initial MUC was successful in 31 shoulders (single group). Repeat MUC was required in 11 shoulders (repeat group). Patients in the single group showed significant improvement in ROM and ASES score at one-year after the procedure (p<0.001); similarly, patients in the repeat group had significant improvement in ROM and ASES score at 3 months and one-year after the procedure (p<0.001). Patients in the repeat group had had significantly more severely limited ROM (p<0.01) and decreased ASES score (p<0.001) before the procedure compared with those in the single group. Conclusions A repeat MUC is a valuable option before proceeding to surgery for recurrence of idiopathic frozen shoulder. When there is severely limited ROM and decreased ASES score before the MUC, a repeat MUC may be　necessary, which would require the patient’s informed consent. Trial registration Retrospectively registered.

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Section: Discussionsupporting

confidence: 90%

The results of repeat manipulation under ultrasound-guided cervical nerve block (MUC) for recurrence of frozen shoulder.

Oshiro¹,

Yagi²,

Harada³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…There has been controversy on the effectiveness of manipulation under anesthesia. Some authors considered manipulation as an effective intervention to be shorten the duration of symptoms [ 11 , 12 , 18 , 25 ], whereas others claimed that the procedure had little effectiveness and traumatizing [ 6 , 9 , 14 ]. In this study, most of the patients in both idiopathic and diabetic groups were successfully treated with manipulation under brachial plexus block and recovered in a few months, which indicated that the procedure certainly shortened the periods of symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Manipulation under ultrasound-guided brachial plexus block was successfully performed in this study as well as under general anesthesia. Recent development of ultrasound technology enabled us to perform brachial plexus block or cervical nerve root block safely and effectively [ 16 - 18 ]. Sasanuma et al .…”

Section: Discussionmentioning

confidence: 99%

“…Others claimed that it had little effectiveness and an arthroscopic capsular release should be considered [ 6 , 9 , 14 , 15 ]. Recent development of ultrasound technology enabled us to perform brachial plexus or cervical nerve root block safely and effectively, but the effectiveness of manipulation under local anesthesia is little reported [ 16 - 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Short-term Clinical Results of Manipulation Under Ultrasound-Guided Brachial Plexus Block in Patients with Idiopathic Frozen Shoulder and Diabetic Secondary Frozen Shoulder

Andõ¹,

Hamada²,

Hagiwara³

et al. 2018

TOORTHJ

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Purpose:This study examined the effectiveness of manipulation under ultrasound-guided brachial plexus block in patients with recalcitrant idiopathic frozen shoulder and diabetic secondary frozen shoulder (diabetic frozen shoulder).Methods:Forty-four idiopathic frozen shoulders and 10 diabetic frozen shoulders with failed conservative treatment for at least 3 months were included in this study. The manipulation was performed under ultrasound-guided brachial plexus block and visual analogue scale, range of motion, and Constant scores were measured before manipulation and at the last follow-up examination.Results:No major complications were observed during the procedure. Sufficient improvement was not obtained in two patients during the procedure and to avoid complications, the procedure was discontinued and subsequently arthroscopic capsular release was performed. Visual analogue scale, range of motion towards all directions, and Constant scores were significantly improved after the manipulation in both the idiopathic frozen shoulder and diabetic frozen shoulder groups, however the diabetic group showed inferior results compared with those of the idiopathic group.Conclusion:This manipulation was effective and shortened the duration of symptoms in most of the idiopathic and diabetic frozen shoulders without major complications during the procedure. Diabetic frozen shoulder showed inferior clinical results and difficulty in recovery in range of motion, which indicated that diabetic frozen shoulder should be discussed as a different entity.

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“…Management of choice involves conservative treatment such as non-steroidal anti-inflammatory drugs (NSAIDs), intra-articular steroids of hyaluronic acid injection, physical therapy, and silent manipulation under cervical nerve root block anesthesia are applied [ 9 – 12 ]. However, Cochrane reviews have demonstrated that the current literature base shows that physiotherapy alone has little to no benefit as compared to control groups [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome of arthroscopic capsular release for frozen shoulder: essential technical points in 255 patients

Kanbe

2018

J Orthop Surg Res

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BackgroundThe purpose of this study was to investigate the long-term clinical outcome and its related factors regarding the severity of adhesion of CH ligament over long head of biceps (LHB) after shoulder arthroscopic capsular release for frozen shoulder with technical points in 255 patients.MethodsWe performed arthroscopic capsular release for frozen shoulder in 267 shoulders of 255 patients, 112 males and 143 females, with mean age of 56.39 years, mean disease duration periods of 0.934 years for conservative treatment, and mean follow-up periods of 5.6 years. The frozen shoulders were divided based on the severity of adhesion between CH ligament over LHB: those with slight degree of synovitis, no adhesion by obtuse rod, and slight thickness of the released capsule (type A), those with moderate degree of synovitis, moderate adhesion of the LHB by obtuse rod, and moderate thickness of the released capsule (type B), and those with severe degree of synovitis, severe adhesion of the LHB by obtuse rod, and severe thickness of the released capsule adhesion and a flatly shaped LHB (type C). We assessed the clinical factors related to the scoring of the shoulders by the criteria of the American Shoulder and Elbow Surgeons (ASES) and the relationship with severity of LHB adhesion.ResultsThe ASES scores improved at 5 years postoperatively in all three groups significantly. The range of motion also significantly improved in all three groups significantly. The severity of the LHB adhesion over the CH ligament was confirmed to influence the ASES scores before and after the arthroscopic capsular release. There was a significant difference between type A and type B (p < 0.0001) or type C (p < 0.0001) before and after surgery. Logistic regression analysis showed disease duration, diabetes mellitus (DM), and ASES score were significantly associated to the severity type of LHB, especially DM has high odds ratio and was a risk factor for LHB adhesion. There is no adverse event including dislocation or axillary nerve injury and recurrence after arthroscopic capsular release at 5 years after surgery.ConclusionsThe long-term results of arthroscopic capsular release in frozen shoulder were confirmed in 255 patients. The severity of LHB adhesion over the CH ligament, a pathological condition related to DM as a risk factor, seems to play an important role in the functional outcome. Therefore, the sufficient release of LHB was essential technical point for arthroscopic capsular release in frozen shoulder.

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Short-term clinical results of frozen shoulder treated with shoulder manipulation under ultrasound-guided cervical nerve root block at outpatient setting: A case series

Cited by 25 publications

References 9 publications

The results of repeat manipulation under ultrasound-guided cervical nerve block (MUC) for recurrence of frozen shoulder.

The results of repeat manipulation under ultrasound-guided cervical nerve block (MUC) for recurrence of frozen shoulder.

Short-term Clinical Results of Manipulation Under Ultrasound-Guided Brachial Plexus Block in Patients with Idiopathic Frozen Shoulder and Diabetic Secondary Frozen Shoulder

Clinical outcome of arthroscopic capsular release for frozen shoulder: essential technical points in 255 patients

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