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Motion and Pain Relief Remain 23 Years After Manipulation Under Anesthesia for Frozen Shoulder

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Manipulation under anesthesia (MUA) as treatment for idiopathic frozen shoulder increases motion, provides pain relief, and restores function, but it is unclear whether the improvements persist long term.

Questions/Purposes

We therefore investigated whether (1) ROM was restored, (2) pain was relieved, and (3) function was restored and maintained after several decades in patients with idiopathic frozen shoulder treated by MUA.

Methods

We followed 15 patients (16 shoulders; 12 in women) at 3 months, 7 years, and 19 to 30 years after MUA for frozen shoulder. Their mean age at MUA was 48.5 years. Four patients had diabetes. The time between the onset of symptoms and manipulation averaged 7.6 months. We determined pain by a patient-generated VAS (range, 0–10; 0 = none, 10 = maximal). We recorded ROM and Constant-Murley scores at last followup.

Results

At 7 years, improvement had occurred in forward flexion to 155°, abduction to 175°, external rotation to 51°, and internal rotation to the T7 level. During the next 16 years, ROM deteriorated by 8° to 23° at last followup, but still equaled ROM of the contralateral shoulder. On the VAS, pain at last followup averaged 1.5 with exertion, 0.3 at rest, and 0.8 at night. The Constant-Murley score was 70 (range, 34–88); 12 patients reached the age- and sex-adjusted normal Constant-Murley score.

Conclusions

In this group of patients treatment of idiopathic frozen shoulder by MUA led to improvement in shoulder motion and function at a mean 23 years after the procedure.

Level of Evidence

Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Carol Norris PhD, for language revision.

Author information

Authors and Affiliations

  1. ORTON Research Institute, Invalid Foundation, Helsinki, Finland

    Heidi Vastamäki MD

  2. ORTON Research Institute and ORTON Orthopaedic Hospital, Helsinki, Finland

    Martti Vastamäki MD, PhD

  3. Elotie 1 A 2, 20780, Kaarina, Finland

    Martti Vastamäki MD, PhD

Authors
  1. Heidi Vastamäki MD
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  2. Martti Vastamäki MD, PhD
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Corresponding author

Correspondence to Martti Vastamäki MD, PhD.

Additional information

The institution of the authors (HV,MV) has received, during the study period, funding from Erityis Valtion Osuus (EVO), Helsinki University Hospital (HUS) (Helsinki, Finland).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for his investigation, that all investigations were concluded in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at ORTON Orthopaedic Hospital, Helsinki, Finland.

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Vastamäki, H., Vastamäki, M. Motion and Pain Relief Remain 23 Years After Manipulation Under Anesthesia for Frozen Shoulder. Clin Orthop Relat Res 471, 1245–1250 (2013). https://doi.org/10.1007/s11999-012-2542-x

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  • DOI: https://doi.org/10.1007/s11999-012-2542-x

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