Translational manipulation after failed arthroscopic capsular release for recalcitrant adhesive capsulitis: a case report.
OBJECTIVE
This article reports the use of translational manipulation after failed arthroscopic capsular release for adhesive capsulitis.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Roubal
Paul J
PJ
Private Practice, Troy, Michigan, USA. thebosspr@comcast.net
Placzek
Jeffrey
J
D000203:Activities of Daily Living; D000328:Adult; D001182:Arthroscopy; D002062:Bursitis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D005260:Female; D018737:Hand Strength; D006801:Humans; D008349:Manipulation, Orthopedic / Q000379:methods*; D008403:Mass Screening; D009407:Nerve Block; D010147:Pain Measurement; D018579:Patient Selection; D016059:Range of Motion, Articular; D012399:Rotation; D012785:Shoulder Joint; D016896:Treatment Outcome