Early Clinical Outcomes of Manipulation under Anesthesia for Refractory Adhesive Capsulitis: Comparison with...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Physical Therapy

Background:

• Refractory adhesive capsulitis (AC) significantly impacts shoulder function and quality of life.
• Current treatment options for AC include conservative management and surgical interventions.
• Identifying optimal early treatment strategies for refractory AC is crucial for patient recovery.

Purpose of the Study:

• To compare the early clinical outcomes of manipulation under anesthesia (MUA) versus arthroscopic capsular release (ACR) in patients with refractory adhesive capsulitis (AC).

Main Methods:

• A comparative study involving 30 patients with refractory AC undergoing MUA (MUA group) and 30 matched patients undergoing ACR (ACR group).
• Clinical outcomes including Visual Analog Scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion (ROM) were assessed preoperatively and at 3, 6, and 12 months post-procedure.
• Statistical analysis was performed to compare the efficacy of MUA and ACR.

Main Results:

• Both MUA and ACR groups demonstrated significant improvements in VAS pain, ASES scores, and ROM at 12 months.
• The MUA group showed significantly better VAS pain and ASES scores at 3 months post-procedure compared to the ACR group.
• Greater mean forward flexion, external rotation, and internal rotation were observed in the MUA group at 3 months, and greater external and internal rotation at 3, 6, and 12 months post-procedure.

Conclusions:

• Manipulation under anesthesia (MUA) provides comparable early clinical outcomes to arthroscopic capsular release (ACR) for refractory adhesive capsulitis (AC).
• MUA is a valuable treatment option that should be considered prior to opting for ACR in managing refractory AC.
• Early MUA can lead to faster pain relief and improved shoulder function in the initial post-operative period.