[Treatment of primary frozen shoulder with manipulation under anesthesia combined with arthroscopy]

To study the feasibility and effectiveness of manipulation under anesthsia combined with arthroscopy for the treatment of primary frozen shoulder.

Thirty-four patients with primary frozen shoulder were treated from January 2006 to March 2009, including 20 males and 14 females with an average age of (56 +/- 3.6) years(ranged from 43 to 62 years). The course of the disease ranged from 9 to 13 months, with a mean time of 11.3 months. All the patient were treated with manipulation under anesthsia combined with arthroscopy. The synovitis of the biceps tendon and the rotator interval was thermo-coagulated, and limited synoviectomy was performed. Subacromial bursoscopy was applied to the patients after glenohumeral arthroscopy. Secondly radiofrequency electrode was used to coagulate bleeding and manipulative relax was performed. All the patients started active and passive postoperative rehabilitation from 1st day after treatment and were followed up for an average of 18.9 months (ranged from 13 to 32 months). The range of motion (ROM) of shoulder joint and feeling of pain calculated by Constant score system were compared before and after the operation.

The post-operative feeling of pain according to Constant score system at 12 months after operation(total 15 points) was (13 +/- 1.58), which was different from that of pre-operative score of (5 +/- 2.60) (P < 0.01). As compared with pre-operative conditions, the motion of shoulder revealed significant improvement at different postoperative stages (P < 0.05). The total post-operative score according to Constant score system at 12 months after operation was (86 +/- 11.20), which was higher than that of pre-operative score of (27 +/- 2.40) (P < 0.01).

Manipulation under anesthsia combined with arthroscopy is an effective, optimal, minimal invasive management with high clinical value for primary frozen shoulder.