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Meyer, C., Stein, G., Kellinghaus, J. and Schneider, T. L. (2015). Management of Idiopathic Frozen Shoulder - Prospective Evaluation of Mobilisation under Anaesthesia and an Additional Subacromial Cortisone Injection. Z. Orthop. Unfallchir., 153 (6). S. 613 - 618. NEW YORK: THIEME MEDICAL PUBL INC. ISSN 1864-6743

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Abstract

Background: Management of primary frozen shoulder is still controversial. Many authors tend to treat patients with an arthroscopic release, if conservative therapy fails. We aimed to demonstrate the efficiency of manipulation under anaesthesia (MUA) in patients with primary frozen shoulder and to contrast the outcome of single MUA with the results of MUA with an additional subacromial injection of cortisone. Material and Methods: A prospective trial with a 1-year follow-up was performed. Between 2008 and 2011 30 patients with idiopathic frozen shoulder underwent MUA, 15 of them received an additional injection of triamcinolone and bupivacain. Thereafter all patients underwent a standardised physiotherapy treatment regime for three months. The patients were assessed for pain, function, range of motion and the Constant-Murley score (CMS) before MUA as well as 1, 6 and 12 months after the intervention. Results: Range of motion increased significantly (p < 0.05) in all planes at every point of follow-up. Preinterventional abduction improved from 65.80 degrees +/- 13.25 to 145.40 degrees +/- 18.50, preinterventional forward flexion from 90.20 degrees +/- 18.98 to 155.60 degrees +/- 13.51 at 1 month after MUA. At this point 80% of patients had returned to work, 66.7% were free of pain. One year after MUA abduction was improved to 173.07 degrees +/- 6.03, forward flexion to 175.47 degrees +/- 4.03. The CMS rose significantly (p < 0.05) from 24.53 +/- 9.28/100 to 73.97 +/- 10.77/100 after 1 month and up to 86.30 +/- 5.62/100 after 1 year. Range of motion and function as described for a healthy shoulder were recognised in every patient during 1 year. However additional subacromial injections of triamcinolone and bupivacain did not lead to a significant improvement. There were no complications reported. Conclusion: This study demonstrates that MUA is a safe and effective tool in the management of idiopathic frozen shoulder, if conservative therapy fails. An additional subacromial injection of cortisone however does not generate a significant improvement.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Meyer, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stein, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kellinghaus, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schneider, T. L. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-384524
DOI:	10.1055/s-0035-1546238
Journal or Publication Title:	Z. Orthop. Unfallchir.
Volume:	153
Number:	6
Page Range:	S. 613 - 618
Date:	2015
Publisher:	THIEME MEDICAL PUBL INC
Place of Publication:	NEW YORK
ISSN:	1864-6743
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ADHESIVE CAPSULITIS; CORTICOSTEROIDS; MANIPULATION; RELEASE Multiple languages Orthopedics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/38452