A Prospective Randomized Trial Comparing Manipulation under Anaesthesia and Capsular Distension for the Treatment of Adhesive Capsulitis of the Shoulder

Abstract

Background We performed a prospective randomised trial recruiting patients with adhesive capsulitis of the shoulder, to undergo either manipulation under anaesthesia (MUA) or capsular distension. Methods Between 2006 and 2010, 28 patients (30 shoulders) were recruited. The mean age was 53 years (44–69). Randomisation was done using a sealed envelope. Results Preoperatively, the MUA group had significantly less mean abduction than the distension group (58.2 ± 5.2° vs. 75.7 ± 5.4°; p = 0.03). At 6 months, the MUA group achieved greater mean abduction (163.0 ± 2.4° vs. 130.7 ± 10.3°; p = 0.02). Preoperatively, the MUA group had significantly less external rotation compared to the distension group (11.0 ± 2.8° vs. 24.0 ± 4.1°; p = 0.03). At 6 months, the external rotation was not statistically different between the groups (40.3 ± 4.0° vs. 40.3 ± 4.6°; p = 0.75). Preoperatively, both groups had similar pain visual analogue score (VAS) (5.7 ± 0.6 vs. 4.7 ± 0.6; p = 0.30) and Disabilities of the Arm, Shoulder and Hand (DASH) scores (49.4 ± 4.7 vs. 53.8 ± 1.6; p = 0.26). However there was no statistically significant difference noted between the groups for VAS (1.5 ± 0.4 vs. 2.9 ± 0.8; p = 0.39) or DASH (12.4 ± 4.3 vs. 25.1 ± 6.4; p = 0.21) at 6-month review. Discussion MUA resulted in better shoulder abduction than capsular distension at 6 months following the procedure. However, there was no significant difference between the two groups in external rotation or pain relief achieved.