[Management of Idiopathic Frozen Shoulder - Prospective Evaluation of Mobilisation under Anaesthesia and an Additional Subacromial Cortisone Injection]. / Management der idiopathischen Schultersteife - prospektive Evaluation der reinen Narkosemobilisation und einer additiven subakromialen Kortikosteroidinjektion.
Z Orthop Unfall
; 153(6): 613-7, 2015 Dec.
Article
en De
| MEDLINE
| ID: mdl-26367143
ABSTRACT
BACKGROUND:
Management of primary frozen shoulder is still controversial. Many authors tend to treat patients with an arthroscopic release, if conservative therapy fails. We aimed to demonstrate the efficiency of manipulation under anaesthesia (MUA) in patients with primary frozen shoulder and to contrast the outcome of single MUA with the results of MUA with an additional subacromial injection of cortisone. MATERIAL ANDMETHODS:
A prospective trial with a 1-year follow-up was performed. Between 2008 and 2011 30 patients with idiopathic frozen shoulder underwent MUA, 15 of them received an additional injection of triamcinolone and bupivacain. Thereafter all patients underwent a standardised physiotherapy treatment regime for three months. The patients were assessed for pain, function, range of motion and the Constant-Murley score (CMS) before MUA as well as 1, 6 and 12 months after the intervention.RESULTS:
Range of motion increased significantly (p < 0.05) in all planes at every point of follow-up. Preinterventional abduction improved from 65.80° ± 13.25 to 145.40° ± 18.50, preinterventional forward flexion from 90.20° ± 18.98 to 155.60° ± 13.51 at 1 month after MUA. At this point 80â% of patients had returned to work, 66.7â% were free of pain. One year after MUA abduction was improved to 173.07° ± 6.03, forward flexion to 175.47° ± 4.03. The CMS rose significantly (p < 0.05) from 24.53 ± 9.28/100 to 73.97 ± 10.77/100 after 1 month and up to 86.30 ± 5.62/100 after 1 year. Range of motion and function as described for a healthy shoulder were recognised in every patient during 1 year. However additional subacromial injections of triamcinolone and bupivacain did not lead to a significant improvement. There were no complications reported.CONCLUSION:
This study demonstrates that MUA is a safe and effective tool in the management of idiopathic frozen shoulder, if conservative therapy fails. An additional subacromial injection of cortisone however does not generate a significant improvement.
Texto completo:
1
Bases de datos:
MEDLINE
Métodos Terapéuticos y Terapias MTCI:
Terapias_manuales
/
Masoterapia
Asunto principal:
Bursitis
/
Cortisona
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Artralgia
/
Manipulaciones Musculoesqueléticas
/
Anestesia General
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
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Etiology_studies
/
Risk_factors_studies
Idioma:
De
Revista:
Z Orthop Unfall
Año:
2015
Tipo del documento:
Article