Shoulder Manipulation After Distention Arthrography: Does Audible Cracking Affect Improvement in Adhesive Capsulitis?...

Area of Science:

• Orthopedics
• Physical Therapy
• Radiology

Background:

• Adhesive capsulitis, or frozen shoulder, causes significant pain and limited range of motion.
• Distention arthrography with manipulation is a common treatment for adhesive capsulitis.
• The clinical significance of audible sounds during manipulation is not well understood.

Purpose of the Study:

• To determine if an audible cracking sound during shoulder manipulation following distention arthrography is clinically significant.
• To assess the impact of this sound on pain, disability, and range of motion outcomes.

Main Methods:

• 48 patients with adhesive capsulitis underwent C-arm-guided distention arthrography and shoulder manipulation.
• Patients were grouped based on the presence (sound group) or absence (non-sound group) of an audible cracking sound.
• Shoulder pain (Numeric Rating Scale, Shoulder Pain and Disability Index) and passive range of motion were assessed pre-procedure and at 3 and 6 weeks post-procedure.

Main Results:

• Both groups showed statistically significant improvements in pain and range of motion at 3 and 6 weeks.
• No significant differences were found between groups, except for external rotation at 6 weeks.
• The sound group demonstrated significantly better external rotation at 6 weeks compared to the non-sound group (p<0.05).

Conclusions:

• Manipulation following distention arthrography is effective for reducing pain and improving shoulder range of motion.
• An audible cracking sound during manipulation may be associated with improved external rotation outcomes.
• The presence of a cracking sound could serve as a positive prognostic indicator for recovery.