The diabetic frozen shoulder: Arthroscopic release

Varjonen²,

2015

Scand J Surg

Background and Aims: idiopathic frozen shoulder can be successfully treated conservatively. manipulation under anesthesia, in randomized controlled studies, has proven to bring no additional benefit to other treatments. however, manipulation under anesthesia still is a used method mainly among patients with unbearable pain or too longstanding restriction of shoulder motion. manipulation under anesthesia may lead to significant improvement in shoulder motion and function. however, the best timing for manipulation under anesthesia is still unclear. we therefore investigated whether timing of manipulation under anesthesia has influence on the results of manipulation under anesthesia, concerning range of motion, pain, and function.Material and Methods: we followed 57 patients (65 shoulders; 31 in women) at 2-14 years after manipulation under anesthesia evaluating range of motion, pain, and function. their mean age at manipulation under anesthesia was 54.0 years. a total of 10 patients had diabetes. the time between the onset of symptoms and manipulation averaged 8.8 months. we formed two groups, those mobilized between 6 and 9 months after the onset of symptoms (Group a, 25 shoulders), and the others (Group b, 40 shoulders). we recorded visual analog scale pain, range of motion, simple shoulder test, and constantmurley scores.Results: patients manipulated between 6 and 9 months after the onset of symptoms had significantly better abduction and external rotation, less pain at rest and at night, and better simple shoulder test than the others.Conclusions: it seems that timing has statistically significant influence on results of manipulation of the idiopathic frozen shoulder. the best time for manipulation under anesthesia, if non-operative treatment has failed to alleviate pain or limitation of shoulder

Section: Introductionmentioning

confidence: 99%

Optimal time for manipulation of frozen shoulder may be between 6 and 9 months

Varjonen²,

2015

Scand J Surg

“…Pathogenesis mechanisms have been proposed, such as endocrine, immunological, and inflammatory processes4. In addition, thyroid diseases, diabetes mellitus, Dupuytren contractures, breast cancer treatment, and autoimmune diseases have been associated with adhesive capsulitis in previous studies56789. Furthermore, patients diagnosed with myocardial infarctions and cerebral vascular diseases are reportedly at risk of adhesive capsulitis1011.…”

mentioning

confidence: 98%

Hyperthyroidism is a Risk Factor for Developing Adhesive Capsulitis of the Shoulder: A Nationwide Longitudinal Population-Based Study

Huang

Lin

Wang

et al. 2014

Sci Rep

The purpose of this study was to investigate the prevalence and risk of adhesive capsulitis among hyperthyroidism patients. The data were obtained from the Longitudinal Health Insurance Database 2005 (LHID 2005) in Taiwan, using 1 million participants and a prospective population-based 7-year cohort study of survival analysis. The ambulatory-care claim records of patients diagnosed according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes relating to hyperthyroidism between January 1, 2004 and December 31, 2007, were obtained. The prevalence and the adjusted hazard ratio (HR) of adhesive capsulitis among hyperthyroid patients and the control group were estimated. Of 4472 hyperthyroid patients, 162 (671/100 000 person-years) experienced adhesive capsulitis during the 24 122 person-year follow-up period. The crude HR of stroke was 1.26 (95% confidence interval [CI], 1.06 to 1.49), which was larger than that of the control group. The adjusted HR of developing adhesive capsulitis was 1.22 (95% CI, 1.03 to 1.45) for hyperthyroid patients during the 7-year follow-up period, which achieved statistical significance. The results of our large-scale longitudinal population-based study indicated that hyperthyroidism is an independent risk factor of developing adhesive capsulitis.

Clinics in Shoulder and Elbow

“…7,[22][23][24] Therefore, it was believed that the anterior capsular structures were required to be released to restore ER and abduction. 14,25) However, none of the studies conducted to date discussed the extent to which the anterior structures need to be released. In addition to the rotator interval, CHL, and middle glenohumeral ligament, Pearsall et al 9) recommended releasing the intra-articular subscapularis tendon without significant morbidity.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Comparative Study of a Standard Anterior Capsular Release versus Inferior Extended Release for the Treatment of Shoulder Stiffness

Alzeyadi¹,

Kim

Park³

et al. 2017

Background: To compare the clinical outcomes of arthroscopic capsular release in patients with and without inferior capsular release for shoulder stiffness. Methods: Between January 2010 and December 2015, 39 patients who underwent arthroscopic capsular release for shoulder stiffness were enrolled and randomized into two groups. In group I, 19 patients underwent arthroscopic capsular release of the rotator interval and anterior capsule. In group II, 20 patients underwent arthroscopic capsular release of the anterior to inferior capsule, including the rotator interval. The American Shoulder and Elbow Surgeons score, Constant scoring system, Simple Shoulder Test, visual analogue scale for pain, and range of motion (ROM) were used for evaluation before surgery, at 3, 6, and 12 months after surgery and on the last follow-up. Results: Preoperative demographic data revealed no significant differences (p>0.05). The average follow-up was 16.07 months. Both groups showed significantly increased ROM at the last follow-up compared with preoperative (p<0.05). At the last follow-up, no statistical differences were found (p>0.05) between groups I and II in functional scores and ROM (forward flexion, p=0.91; side external rotation, p=0.17; abduction external rotation, p=0.72; internal rotation, p=0.61). But we found that group II gained more flexion compared to group I at 3 months and 6 months (p<0.05) after the surgery. Conclusions: Both techniques of capsular release are effective for stiffness shoulder. However, the extended inferior capsular release shows superiority in forward flexion over anterior capsular release alone during 6 months of follows-up (level of evidence: Level I, therapeutic randomized controlled trial). (Clin Shoulder Elbow 2017;20(3):117-125)