Abstract
Purpose
To prospectively evaluate a cohort of patients with adhesive capsulitis and identify predictors of failure of conservative treatment in the first 2 months of therapy.
Methods
This was a single-cohort, prospective observational study that included 20 participants (13 females/7 males; median age of 51.8 years [interquartile range: 8.65]) with primary adhesive capsulitis managed conservatively and evaluated clinically every month for at least 2 years of follow-up (29 [5] months). The evaluation included stage of the disease, treatment applied, radiological findings, pain levels and range of motion (active and passive ROM in the four planes and isolated glenohumeral passive ROM in abduction [GH-ABD], external rotation [GH-ER] and internal rotation). The main outcome assessed was failure of conservative treatment defined as the need for surgery and persistent pain or CMS below 70 points at the 1-year follow-up.
Results
Seven patients (7/20, 35%) were considered to have failed conservative treatment because they required arthroscopic capsular release 5.2 (2.1) months after the initial diagnosis. Of all the clinical and epidemiological variables, absence of improvement during the first 2 months in isolated glenohumeral ROM abduction and external rotation predicted failure of conservative treatment: improvement in GH-ABD (10° or more) occurred in 10/13 patients in the conservative treatment group and in 1/7 patients in the surgery group (p = 0.017). Improvement in GH-ER (10° or more) occurred in 9/13 patients in the conservative treatment group and in 0/7 patients in the surgery group (p = 0.005).
Conclusions
Precise assessment of isolated glenohumeral ROM in patients with adhesive capsulitis can help identify patients in which conservative treatment might fail. In this study, patients who did not experience early improvements in isolated glenohumeral ROM often required surgery.
Level of evidence
III (Prospective cohort study).
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References
Benjamini Y, Hochberg Y (1995) Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Ser B (Methodol) 57(1):289–300. https://doi.org/10.1111/j.2517-6161.1995.tb02031.x
Fields BKK, Skalski MR, Patel DB, White EA, Tomasian A, Gross JS, Matcuk GR Jr (2019) Adhesive capsulitis: review of imaging findings, pathophysiology, clinical presentation, and treatment options. Skeletal Radiol 48(8):1171–1184. https://doi.org/10.1007/s00256-018-3139-6
Forsythe B, Lavoie-Gagne O, Patel BH, Lu Y, Ritz E, Chahla J, Okoroha KR, Allen AA, Nwachukwu BU (2020) Efficacy of arthroscopic surgery in the management of adhesive capsulitis: a systematic review and network meta-analysis of randomized controlled trials. Arthroscopy. https://doi.org/10.1016/j.arthro.2020.09.041
Hand C, Clipsham K, Rees JL, Carr AJ (2008) Long-term outcome of frozen shoulder. J Shoulder Elbow Surg 17(2):231–236. https://doi.org/10.1016/j.jse.2007.05.009
Kingston K, Curry EJ, Galvin JW, Li X (2018) Shoulder adhesive capsulitis: epidemiology and predictors of surgery. J Shoulder Elbow Surg 27(8):1437–1443. https://doi.org/10.1016/j.jse.2018.04.004
Kraal T, Lubbers J, van den Bekerom MPJ, Alessie J, van Kooyk Y, Eygendaal D, Koorevaar RCT (2020) The puzzling pathophysiology of frozen shoulders—a scoping review. J Exp Orthop 7(1):91. https://doi.org/10.1186/s40634-020-00307-w
Ladermann A, Piotton S, Abrassart S, Mazzolari A, Ibrahim M, Stirling P (2021) Hydrodilatation with corticosteroids is the most effective conservative management for frozen shoulder. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-020-06390-x
Le HV, Lee SJ, Nazarian A, Rodriguez EK (2017) Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder Elbow 9(2):75–84. https://doi.org/10.1177/1758573216676786
Lee M, Theodoulou A, Krishnan J (2018) Criteria used for diagnosis of adhesive capsulitis of the shoulder: a scoping review protocol. JBI Database Syst Rev Implement Rep 16(6):1332–1337. https://doi.org/10.11124/JBISRIR-2017-003609
Loew M, Heichel TO, Lehner B (2005) Intraarticular lesions in primary frozen shoulder after manipulation under general anesthesia. J Shoulder Elbow Surg 14(1):16–21. https://doi.org/10.1016/j.jse.2004.04.004
Mun SW, Baek CH (2016) Clinical efficacy of hydrodistention with joint manipulation under interscalene block compared with intra-articular corticosteroid injection for frozen shoulder: a prospective randomized controlled study. J Shoulder Elbow Surg 25(12):1937–1943. https://doi.org/10.1016/j.jse.2016.09.021
Neviaser JS (1962) Adhesive capsulitis of the shoulder (the frozen shoulder). Med Times 90:783–807
Ramirez J (2019) Adhesive capsulitis: diagnosis and management. Am Fam Phys 99(5):297–300
Rangan A, Brealey SD, Keding A, Corbacho B, Northgraves M, Kottam L, Goodchild L, Srikesavan C, Rex S, Charalambous CP, Hanchard N, Armstrong A, Brooksbank A, Carr A, Cooper C, Dias JJ, Donnelly I, Hewitt C, Lamb SE, McDaid C, Richardson G, Rodgers S, Sharp E, Spencer S, Torgerson D, Toye F, Group UFS (2020) Management of adults with primary frozen shoulder in secondary care (UK FROST): a multicentre, pragmatic, three-arm, superiority randomised clinical trial. Lancet 396(10256):977–989. https://doi.org/10.1016/S0140-6736(20)31965-6
Redler LH, Dennis ER (2019) Treatment of adhesive capsulitis of the shoulder. J Am Acad Orthop Surg 27(12):e544–e554. https://doi.org/10.5435/jaaos-d-17-00606
Ruiz Iban MA, Alonso Guemes S, Ruiz Diaz R, Asenjo Gismero CV, Lorente Gomez A, Diaz Heredia J (2021) Evaluation of the inter and intraobserver reproducibility of the GRASP method: a goniometric method to measure the isolated glenohumeral range of motion in the shoulder joint. J Exp Orthop 8(1):37. https://doi.org/10.1186/s40634-021-00352-z
Shaffer B, Tibone JE, Kerlan RK (1992) Frozen shoulder. A long-term follow-up. J Bone Joint Surg Am 74(5):738–746
Yoon JP, Chung SW, Lee BJ, Kim HS, Yi JH, Lee HJ, Jeong WJ, Moon SG, Oh KS, Yoon ST (2017) Correlations of magnetic resonance imaging findings with clinical symptom severity and prognosis of frozen shoulder. Knee Surg Sports Traumatol Arthrosc 25(10):3242–3250. https://doi.org/10.1007/s00167-015-3887-y
Zhang J, Zhong S, Tan T, Li J, Liu S, Cheng R, Tian L, Zhang L, Wang Y, Liu F, Zhou P, Ye X (2020) Comparative efficacy and patient- specific moderating factors of nonsurgical treatment strategies for frozen shoulder: an updated systematic review and network meta-analysis. Am J Sports Med 2020:363546520956293. https://doi.org/10.1177/0363546520956293
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The study was approved by the Clinical Investigation and Ethics Committee of the Hospital Universitario Ramoón y Cajal, Madrid, Spain (IRB approval number 114/20).
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Ruiz Ibán, M.A., Alonso Güemes, S., Ruiz Díaz, R. et al. Assessment of isolated glenohumeral range of motion in patients with adhesive capsulitis can help predict failure of conservative treatment: a pilot study. Knee Surg Sports Traumatol Arthrosc 30, 2099–2104 (2022). https://doi.org/10.1007/s00167-021-06804-4
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DOI: https://doi.org/10.1007/s00167-021-06804-4