The Role of Surgery in Frozen Shoulder

Chambler, Andrew; Carr, Andrew

doi:10.1302/0301-620x.85b6.14379

Cited by 55 publications

(40 citation statements)

References 84 publications

(66 reference statements)

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“…Non-surgical forms of treatment include supervised neglect, analgesia, selfdirected exercise, formal physiotherapy and intra-articular injections of corticosteroid, local anaesthetic or both, nerve blockade and hydrodistention. 3 Further treatment, including surgery, is reserved for resistant cases or functionally compromised patients. Options include manipulation under anaesthesia [4][5][6] with or without corticosteroid and local anaesthetic injection, arthroscopic release 7 and open release.…”

mentioning

confidence: 99%

Treatment of frozen shoulder by manipulation under anaesthetic and injection

Thomas

Jenkins

Owen

et al. 2011

The Journal of Bone and Joint Surgery. British volume

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The effect of timing of a manipulation under anaesthetic (MUA) and injection of corticosteroid and local anaesthetic for the treatment of frozen shoulder has attracted little attention to date. All studies describe a period of conservative treatment before proceeding to an MUA. Delay has been associated with a poorer outcome. We present a retrospective review of a prospectively collected, single-surgeon, consecutive series of 246 patients with a primary frozen shoulder treated by MUA within four weeks of presentation. The mean duration of presenting symptoms was 28 weeks (6 to 156), and time to initial post-operative assessment was 26 days (5 to 126). The Oxford shoulder score (OSS) improved by a mean of 16 points (Wilcoxon signed-ranks test, p < 0.001) with a mean OSS at this time of 43 (7 to 48). Linear regression analysis showed no correlation between the duration of presenting symptoms and OSS at initial follow-up (R2 < 0.001) or peri-operative change in OSS (R2 < 0.001) or OSS at long-term follow-up (R2 < 0.03). Further analysis at a mean of 42 months (8 to 127) revealed a sustained improvement with a mean OSS of 44 (16 to 48). A good outcome follows an MUA and injection of corticosteroid and local anaesthetic in patients with primary frozen shoulder, independent of the duration of the presenting symptoms, and this improvement is maintained in the long term.

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mentioning

confidence: 99%

Treatment of frozen shoulder by manipulation under anaesthetic and injection

Thomas

Jenkins

Owen

et al. 2011

The Journal of Bone and Joint Surgery. British volume

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“…16 If untreated, frozen shoulder has been noted to last up to 3 years and does tend to appear in the same shoulder again. 15 Physiotherapy, 4 cortisone injections, 1,20 oral cortisone, 3 manipulation under anesthesia, 11,13 release of adhesions arthroscopically, 6 and manipulation under anesthesia followed by arthroscopy 5 have all been used in attempts to shorten the duration of shoulder symptoms. There is little evidence to support or refute the efficiency of these procedures.…”

mentioning

confidence: 99%

Manipulation under anesthesia with home exercises versus home exercises alone in the treatment of frozen shoulder: A randomized, controlled trial with 125 patients

Kivimaki

Pohjolainen

Malmivaara³

et al. 2007

Journal of Shoulder and Elbow Surgery

132

122

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“…22 Patients with type 1 diabetes are at increased risk of this disorder. 23 the prevalence of frozen shoulder has been estimated at between 2% and 5%.…”

Section: Frozen Shouldermentioning

confidence: 99%

“…the details of the patho physiological processes underlying this disease remain elusive; however, there seems to be a common pathway of inflammation and fibrosis resulting in cap sular contracture. 22 Frozen shoulder is generally regarded as a self-limiting condition, 27 and only rarely (in less than 5% of those presenting in secondary care) leads to long-term disability with restricted range of movement and persistent pain. 28 the natural history is usually described as passing through three stages: a 'freezing' or initial painful phase lasting up to 6 months, a 'frozen' or stiff phase of 6-18 months and a 'thawing' or recovery phase of 6-12 months.…”

Section: Frozen Shouldermentioning

confidence: 99%

Surgical options for patients with shoulder pain

et al. 2010

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Shoulder pain is a common musculoskeletal complaint in the community, which can arise from diverse causes. Regardless of the cause, mild cases can often be effectively treated conservatively, with options including rest, physiotherapy, pain relief and glucocorticoid injections. If conservative strategies fail after a 3-6 month period then surgery might be considered. Generally, the proportion of patients with shoulder pain who require surgery is small. When surgery is considered, a clear diagnosis and structural information from imaging are required. The indications for surgery, and success rate, depend on the specific diagnosis as well as on the individual clinical presentation. Evidence from case series suggest that surgical interventions for shoulder pain are effective when used appropriately. This article outlines the surgical management of the most common painful conditions that affect the shoulder, including impingement, rotator cuff tear, frozen shoulder, osteoarthritis, rheumatoid arthritis and calcific tendonitis.

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The Role of Surgery in Frozen Shoulder

Cited by 55 publications

References 84 publications

Treatment of frozen shoulder by manipulation under anaesthetic and injection

Treatment of frozen shoulder by manipulation under anaesthetic and injection

Manipulation under anesthesia with home exercises versus home exercises alone in the treatment of frozen shoulder: A randomized, controlled trial with 125 patients

Surgical options for patients with shoulder pain

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