Frozen Shoulder ...Is Manipulation Under Anaesthesia a good option?
Reference:Kivim�ki J, et al Manipulation under anesthesia with home exercises versus home exercises alone in the treatment of frozen shoulder: a randomized, controlled trial with 125 patients J Shoulder Elbow Surg. 2007 Nov-Dec;16(6):722-6. Epub 2007 Oct 10.
Question: Is there a benefit to manipulation under anaesthesia in frozen shoulder patients?
The Study: This was a blinded randomized trial with a 1-year follow-up, conducted in Finland.
125 patients with frozen shoulder were randomized to either a manipulation group or control group. All the patients in BOTH groups received specific therapeutic exercises by physiotherapists.
The Result: Although quite small, improvements in ROM were noted immediately after the manipulation, but 3, 6 and 12 months later, the 2 groups were SIMILAR with respect to pain and function.
Interestingly, after 1 year, both groups had only minimal pain and functional loss.
Clinical Relevance: If your patient asks you, “Should I get the orthopaedic surgeon to try manipulation under anaesthesia on my shoulder?”
You may simply answer, “Based on this study published in the Journal of Bone and Joint Surgery, Physiotherapy and home exercises were just as effective as manipulation in the short and long term. Just appreciate that this condition will take several months to fully resolve!”
Posted on: February 02, 2008