RESUMO
The patient was a 61-year-old woman who underwent long-lever manipulation under anesthesia (MUA) for adhesive capsulitis. Two weeks following MUA, the constellation of clinical findings raised concern for possible adverse outcomes. Radiographs were obtained, as well as subsequent magnetic resonance imaging and computed tomography scans. Images revealed anterior shoulder dislocation with Bankart and Hill-Sachs lesions, and an anterior rotator cuff tear. J Orthop Sports Phys Ther 2016;46(8):707. doi:10.2519/jospt.2016.0412.
Assuntos
Bursite/terapia , Manipulações Musculoesqueléticas/efeitos adversos , Lesões do Manguito Rotador/etiologia , Luxação do Ombro/etiologia , Articulação do Ombro , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Radiografia , Recuperação de Função Fisiológica , Lesões do Manguito Rotador/diagnóstico por imagem , Luxação do Ombro/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: This article reports the use of translational manipulation after failed arthroscopic capsular release for adhesive capsulitis. CLINICAL FEATURES: The patient was a 40-year-old woman, insulin-dependent diabetic with the insidious onset of right shoulder adhesive capsulitis. The patient underwent physical therapy 3 times a week for 6 weeks with minimal changes in her range of motion or pain. After failing physical therapy, the patient had arthroscopic capsular release and long-lever arm rotational manipulation of the right shoulder. The patient participated in physical therapy again, failing to regain her range of motion. INTERVENTION AND OUTCOME: Subsequently, the patient underwent interscalene block and translational manipulation by the same therapist followed by physical therapy. The patient's range-of-motion measures, strength testing, pain scale measurements, and functional scoring were recorded throughout her rehabilitation. She returned 2 years postdischarge for the same tests and measurements. CONCLUSION: Adhesive capsulitis in association with diabetes mellitus poses a serious treatment dilemma. Arthroscopic release may have limited benefits secondary to limited release and/or postoperative pain limiting rehabilitation. Translational manipulation under interscalene block may be considered in this difficult treatment group.