Manipulation or intra-articular steroids in the management of adhesive capsulitis of the shoulder? A prospective randomized trial.
BACKGROUND
The management of adhesive capsulitis (frozen shoulder) is controversial. The authors present a prospective randomized study comparing the outcome, at a two-year follow-up period, of two groups of patients treated either by manipulation of the shoulder under anaesthetic or by intra-articular shoulder injections using steroid with distension.


METHODS
Fifty-three patients suffering from Idiopathic "Primary" Frozen Shoulder were prospectively randomized into two treatment groups and followed up for two years from the start of treatment. Patients were assessed using the Constant score, a Visual Analogue Score, and the SF36 questionnaire.


RESULTS
No statistical differences were found between the two groups of patients with regards to the outcome measures.


CONCLUSIONS
Treatment using steroid injections with distension as an out-patient is therefore recommended for the treatment of Idiopathic "Primary" Frozen Shoulder. This has the same clinical outcome as a manipulation under anaesthetic with less attendant risks.
Jacobs
Leo G
LG
Department of Orthopaedics, Royal Oldham Hospital, Oldham, Lancashire, United Kingdom.
Smith
Matthew Guy
MG
Khan
Sohail A
SA
Smith
Karen
K
Joshi
Miland
M
D000328:Adult; D000368:Aged; D002062:Bursitis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000534:rehabilitation*; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011336:Probability; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012785:Shoulder Joint; D013256:Steroids / Q000627:therapeutic use*; D016896:Treatment Outcome
D013256:Steroids