Related Experiment Videos
The resistant frozen shoulder. Manipulation versus arthroscopic release
D J Ogilvie-Harris1, D J Biggs, D P Fitsialos
1University of Toronto, Toronto Hospital, Toronto Western Division, Ontario, Canada.
Clinical Orthopaedics and Related Research
|October 1, 1995
Summary
Arthroscopic division of contracted shoulder structures offers better pain relief and function than manipulation for frozen shoulder. Early intervention may benefit diabetic patients with this condition.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
Background:
- Frozen shoulder (adhesive capsulitis) often resolves but can cause persistent pain, stiffness, and functional loss in 10% of patients.
- Conventional treatments may fail for long-standing frozen shoulder cases.
Purpose of the Study:
- To compare the efficacy of arthroscopic division of contracted structures versus arthroscopic manipulation for treating persistent frozen shoulder.
Main Methods:
- A prospective cohort study involved 40 patients with frozen shoulder unresponsive to conventional treatment for at least one year.
- Group 1 (n=20): Arthroscopic manipulation before and after arthroscopy.
- Group 2 (n=20): Arthroscopic division of contracted capsular and ligamentous structures in four sequential steps.
Main Results:
- Both groups showed similar restoration of range of motion.
- Arthroscopic division resulted in significantly better pain relief and functional recovery.
- Excellent outcomes were achieved in 15/20 patients with arthroscopic division versus 7/18 with arthroscopic manipulation.
- Diabetic patients initially fared worse but achieved similar outcomes; early intervention is suggested.
Conclusions:
- Arthroscopic division of contracted shoulder structures is a superior treatment for persistent frozen shoulder compared to arthroscopic manipulation, offering better pain relief and functional outcomes.
- Patients with diabetes may benefit from early surgical intervention for frozen shoulder.