A capsular dilatation facilitated shoulder manipulation for treating patients with frozen shoulder

Abstract

Forty patients with a diagnosis of frozen shoulder who had symptom for an average of 8 months and failed conservative treatment of at least 6 weeks of physical therapy were treated with capsular dilatation facilitated shoulder manipulation. Post-manipulation, the patient underwent arthroscopy for visualization, fibrin debridement and bleeding point coagulation. All the essential intraarticular structures ie, glenohumeral ligament, rotator cuff were intact. Post-operatively, all patients revealed substantial gain in shoulder range of motion as well as diminished shoulder pain. The average flexion, abduction, and internal rotation gain were 76.9±8.9, 18.1±5.7, 9.6±7.1 degrees respectively. External rotation gain in the position of 90° shoulder abduction and shoulder adduction were 53.0± 9.97 and 31.4±7.2 degrees respectively. The average pain score by visual analogue scale pre and 6-month post-manipulation were 80.6±8.6 and 7.6±7.3 respectively with the average of pain score of 73.0±10.4. The authors proposed an effective and safe technique employing intra-articular pressure to facilitate shoulder manipulation in order to treat frozen shoulder.