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

• Published in: International orthopaedics 2022-11, Vol.46 (11), p.2593-2601
• Main Authors: Sundararajan, Silvampatti Ramasamy, Dsouza, Terence, Rajagopalakrishnan, Ramakanth, BT, Pushpa, Arumugam, Palanisamy, Rajasekaran, Shanmuganathan
• Format: Article
• Language: English
• Subjects: Anesthesia; Arthroscopy - adverse effects; Arthroscopy - methods; Bursitis - surgery; Humans; Joint Capsule Release - methods; Medicine; Medicine & Public Health; Original Paper; Orthopedics; Pain; Prospective Studies; Range of Motion, Articular; Shoulder Joint - surgery; Treatment Outcome
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-022-05558-z

Purpose Arthroscopic capsular release (ACR) and Manipulation under anaesthesia(MUA) have been widely used in the treatment of frozen shoulder (FS). However, there is only limited Level-I evidence to prefer ACR over MUA. The purpose of our study was to conduct a randomised trial comparing ACR versus MUA to assess the difference in outcome, complications and cost-effectiveness of both procedures. Methods From May 2020 to June 2021, patients presenting with FS were randomised into two groups ACR ( n  = 44) and MUA ( n  = 41). Patients with arthritis, full-thickness cuff tears, history of trauma/previous surgery around the shoulder were excluded from the study. Range of movement (ROM), pain grading using visual analogue scale (VAS), functional scores- UCLA, CONSTANT and EuroQol-5D scores were measured pre-operatively and post-operatively. MRI was done at three weeks post-operatively for screening complications of either procedure. Quality-adjusted life years (QALY) was used for cost-analysis. Results Post-operatively, patients had significant improvement in pain, ROM and functional scores in both groups ( P