Manipulation under anesthesia for frozen shoulders : a retrospective cohort study


Frozen Shoulder ; adhesive capsulitis ; manipulation

Published online: Dec 31 2019

Tim Kraal, Oetz Van der Meer, Maaike Van den Borne, Koen Koenraadt, Denise Eygendaal, Ronald Boer

From the Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands


Abbreviations: MUA, manipulation under anesthesia ; FS, frozen shoulder ; SPADI, Shoulder Pain and Disability Score ; OSS, Oxford Shoulder Score ; NPRS, Numeric Paind Rating Scale.

Manipulation under anesthesia is a well-established, but controversial, treatment for frozen shoulders. We will evaluate our results of manipulation and physiotherapy in stage two frozen shoulders. Questionnaires were sent to 65 patients with stage 2 frozen shoulders, treated with manipulation under anaesthesia between January 2012 and January 2014. Outcome parameters consisted of SPADI, OSS, EQ- 5D, pain and satisfaction.

A response rate of 75% was obtained. Mean follow up was 21 months (range 11-36). The median SPADI score was 11.2 (IQR 0.8-25.2) and median OSS was 39.0 (IQR 30-43). Only 72% of patients reported that they reached their pre injury level of functioning. A satisfaction rate of 92% was reported.

Manipulation is a relatively easy intervention with a high satisfaction rate. We assume that manipulation could shorten the duration of symptoms. However, this needs to be confirmed in a randomized trial with a control group.