Improved PROMs and Less Post-op Pain at 6 months with ACR and MUA compared to MUA Alone in Patients with Resistant Frozen Shoulder

Abstract

effectiveness of arthroscopic capsular release (ACR) with manipulation under anesthesia (MUA) versus MUA alone in patients with resistant frozen shoulder, specifically focusing on patient-reported outcome measures (PROMs) and postoperative pain levels at 6 months. Methodology: This retrospectively analyzed study was conducted at Allied Hospital, Faisalabad, from June 2019 to August 1st, 2022. The data of 50 patients who underwent ACR with MUA (Group A) and MUA alone (Group B) were analyzed retrospectively. Patients were assessed preoperatively using the VAS pain scale, ASES, OSS, and range of motion (ROM). Preoperative results were compared to postoperative results taken 6 months postoperatively. The results were analyzed using SPSS. Independent t-tests and paired sample t-tests were used to assess significant differences between the two groups. Results: The mean age was 57 years with a mean duration of symptoms prior to surgery of 23 months. Both groups experienced a significant difference in the VAS pain scale, ASES, OSS, and ROM (p < 0.05). Patients treated with ACR and MUA (Group A) experienced significantly lower postoperative pain compared to patients treated with MUA alone (Group B) (16.68 vs. 23.72), as well as higher ASES (71.40 vs. 66.64) and OSS (37.68 vs. 34.04) scores, respectively (p < 0.05). The ROM was slightly higher in Group A; however, it was statistically insignificant. Conclusion: ACR with MUA and MUA alone are effective treatments for adhesive capsulitis. ACR with MUA provides better pain relief and functional shoulder outcomes in the early postoperative period and at 6 months. Further studies are needed to confirm these results.