The effect of shoulder manipulation on rotator cuff integrity

Area of Science:

• Orthopedics
• Sports Medicine
• Physical Therapy

Background:

• Frozen shoulder (adhesive capsulitis) treatment often involves controversial methods like shoulder manipulation under anesthesia (MUA).
• Potential risks include fractures and neurological damage, with concerns about iatrogenic rotator cuff tears, though incidence is unreported.

Purpose of the Study:

• To evaluate the impact of shoulder manipulation on the integrity of the rotator cuff in patients with frozen shoulder.

Main Methods:

• A prospective study involving 32 patients (33 shoulders) with frozen shoulder undergoing MUA.
• Ultrasound assessments of the rotator cuff were performed before and 3 weeks after MUA.
• Patients were evaluated for range of motion and strength pre- and post-procedure.

Main Results:

• No rotator cuff tears were detected on ultrasound before or after MUA in any patient.
• Significant improvements were observed in forward flexion (81.2°), abduction (102.6°), external rotation (49.4°), and internal rotation (3.5 levels).
• No fractures, dislocations, or nerve palsies occurred.

Conclusions:

• Shoulder manipulation for frozen shoulder did not result in rotator cuff tears in this study.
• The procedure appears safe and effective for improving range of motion and function when performed correctly.