Arthroscopic release for frozen shoulder: Does the timing of intervention and diabetes affect outcome?

Yu-De Su, Tien-Ching Lee, Yu-Chuan Lin, Shen-Kai Chen, Yu-De Su, Tien-Ching Lee, Yu-Chuan Lin, Shen-Kai Chen

Abstract

Purpose: To evaluate the effect of timing of arthroscopic release and manipulation under anesthesia for frozen shoulder in patients with diabetes and non-diabetes.

Methods: One hundred and twenty-seven patients with frozen shoulder were included in the study. Each patient was assigned to: 1) one of four groups according to the duration from symptom onset to surgery (group A: ≤3 months; group B: 3-6 months; group C: 6-12 months; group D: >12 months), 2) diabetic or nondiabetic group. The outcomes were measured by shoulder range of motion (ROM), Disabilities of the Arm, Shoulder, and Hand (DASH) score, American Shoulder and Elbow Surgeons (ASES) Shoulder score, the period of pain relief, overall duration of disease, and satisfaction.

Results: All the patients got great improvement in shoulder ROM (P < .0001) after arthroscopic surgery, but there was no statistical difference in the pre-operative and post-operative shoulder ROM between the four groups and between diabetic and nondiabetic groups. The overall duration of disease was mean 55.4~68.7 weeks, which demonstrated much shorter disease course compared with nature course. Improvement were also seen in shoulder ROM at one week to one month, and the period of total pain relief was at a mean time of 3.7 to 3.8 weeks. There were higher ASES Shoulder score in group B than in group C (P = 0.02) and higher DASH score in diabetic group in short term follow-up.

Conclusions: Arthroscopic release provides effective and rapid improvements to shoulder motion and function, unrelated to the timing of surgery, in patients with frozen shoulder. The diabetic patients do not have functional outcomes as good as the nondiabetic patient at short-term follow-up.

Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. Favejee MM, Huisstede BM, Koes BW. Frozen shoulder: the effectiveness of conservative and surgical interventions—systematic review. Br J Sports Med 2011; 45(1): 49–56 10.1136/bjsm.2010.071431
    1. Mukherjee RN, Pandey RM, Nag HL, Mittal R. Frozen shoulder—A prospective randomized clinical trial. World J Orthop 2017;5:394–399.
    1. Hand GCR, Athanasou NA, Matthews T, Carr AJ. The pathology of frozen shoulder. J Bone Joint Surg Br 2007;89(7): 928–932. 10.1302/0301-620X.89B7.19097
    1. Robinson CM, M Seah KT, Chee YH, Hindle P, Murray IR. Frozen shoulder. J Bone Joint Surg Br 2012;94(1): 1–9 10.1302/0301-620X.94B1.27093
    1. Wong PL, Tan HC. A review on frozen shoulder. Singapore Med J 2010;51(9): 694–697
    1. Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA. Current review of adhesive capsulitis. J Shoulder Elbow Surg 2011;20(3): 502–514. 10.1016/j.jse.2010.08.023
    1. Chambler A. F. and Carr A. J. The role of surgery in frozen shoulder. J Bone Joint Surg Br 2003;85(6): 789–95
    1. Sunil Sharma. Management of frozen shoulder—conservative vs surgical? Ann R Coll Surg Engl 2011;93(5): 343–344; discussion 345–346. 10.1308/147870811X582080
    1. Cho CH, Kim DH, Lee YK. Serial Comparison of Clinical Outcomes after Arthroscopic Capsular Release for Refractory Frozen Shoulder With and Without Diabetes. J. Arthroscopy. 2016,Vol 32, No 8(August);1515–1520
    1. Mehta SS, Singh HP, Pandey R. Comparative outcome of arthroscopic release for frozen shoulder in patients with and without diabetes. J Bone Joint Surg Br 2014;96-B: 1355–8
    1. Massoud SN, Pearse EO, Levy O, Copeland SA.Operative management of the frozen shoulder in patients with diabetes. J. Shoulder Elbow Surg 2002;11:609–13 10.1067/mse.2002.127301
    1. Thomas WJ, Jenkins EF, Owen JM, Sangster MJ, Kirubanandan R, Beynon C, et al. Treatment of frozen shoulder by manipulation under anaesthetic and injection: does the timing of treatment affect the outcome? J Bone Joint Surg Br 2011;93(10):1377–1381. 10.1302/0301-620X.93B10.27224
    1. Berghs BM, Sole-Molins X, Bunker TD. Arthroscopic release of adhesive capsulitis. J Shoulder Elbow Surg 2004;13(2): 180–185. 10.1016/S1058274603003094
    1. Chen SK, Chou PH, Lue YJ, Lu YM. Treatment for frozen shoulder combined with calcific tendinitis of the supraspinatus. Kaohsiung J Med Sci 2008;24(2): 78–84. 10.1016/S1607-551X(08)70101-3
    1. Richards RR, An KN, Bigliani LU, Friedman RJ, Gartsman GM, Gristina AG, et al. A standardized method for the assessment of shoulder function. J. Shoulder Elbow Surg 1994;3:347–52 10.1016/S1058-2746(09)80019-0
    1. Hand C, Clipsham K, Rees JL, Carr AJ. Long-term outcome of frozen shoulder. J Shoulder Elbow Surg 2008;17(2):231–6. 10.1016/j.jse.2007.05.009
    1. Dattani R, Ramasamy V, Parker R, Patel VR. Improvement in quality of life after arthroscopic capsular release for contracture of the shoulder. Bone Joint J 2013;95:942–946. 10.1302/0301-620X.95B7.31197
    1. Le Lievre HM. and Murrell GA. Long-term outcomes after arthroscopic capsular release for idiopathic adhesive capsulitis. J Bone Joint Surg Am 2012;94(13): 1208–1216. 10.2106/JBJS.J.00952
    1. Baums MH, Spahn G, Nozaki M, Steckel H, Schultz W, Klinger HM. Functional outcome and general health status in patients after arthroscopic release in adhesive capsulitis. Knee Surg Sports Traumatol Arthrosc 2007;15: 638–644 10.1007/s00167-006-0203-x
    1. Smith CD, Hamer P, Bunker TD. Arthroscopic capsular release for idiopathic frozen shoulder with intra-articular injection and a controlled manipulation. Ann R Coll Surg Engl 2014;96(1) 55–60. 10.1308/003588414X13824511650452

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