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General Orthopaedics

FROZEN SHOULDER: MANIPULATION UNDER ANAESTHESIA OR MANIPULATION UNDER ANAESTHESIA AND ARTHROSCOPIC CAPSULAR RELEASE – WHICH IS THE BETTER TREATMENT MODALITY?

British Orthopaedic Association (BOA) 2006



Abstract

Background

Frozen Shoulder is a common condition which causes significant morbidity in people of working age. The 2 most popular forms of surgical treatment for this condition are Manipulation under Anaesthesia (MUA) or MUA plus Arthroscopic Capsular Release (ACR). Both treatment modalities are known to give good results, but no-one has compared the two to see which is better.

Aim

To compare the outcome in patients with primary frozen shoulder, who are treated by either MUA or MUA plus ACR.

Methods

56 patients with primary frozen shoulder were treated by either MUA or MUA plus ACR. Each patient had their American Shoulder and Elbow Score (ASES), and their Oxford Shoulder Score (OSS) measured pre- and post-operatively.

Results

The patients who had MUA plus ACR had a mean ASES of 19.6 pre-operatively, 78.3 at 6 months, and a mean of 80.1 at 12 months. The mean OSS was 32.5 pre-operatively, 53.6 at 6 months and 53.8 at 12 months. The patients who had a MUA had a mean ASES of 28.7 pre-operatively, 57.9 at 6 months and 58 at 12 months. The mean OSS was 33 pre-operatively, 42.5 at 6 months and 48 at 12 months.

Conclusions

Both treatments give good results; MUA plus ACR give significantly superior results at 6 to 12 months post-operatively. However, there is no significant difference beyond 12 months.