Abstract
BackgroundThis study aimed to evaluate the clinical results of a repeat manipulation under ultrasound-guided cervical nerve root block (MUC) with corticosteroid and local anesthetic injection for recurrence of idiopathic frozen shoulder after MUC.MethodsA consecutive series of 42 shoulders in 39 patients with idiopathic frozen shoulder underwent MUC. All patients were assessed according to the American Shoulder Elbow Surgeon (ASES) score and shoulder range of motion (ROM) both before MUC and at one-year thereafter. If patients continued to have pain and limited ROM at 3 months after the procedure, they were offered a repeat MUC. Such patients were also assessed before the procedure and at 3 months and one-year thereafter.Results The initial MUC was successful in 31 shoulders (single group). Repeat MUC was required in 11 shoulders (repeat group). Patients in the single group showed significant improvement in ROM and ASES score at one-year after the procedure (p<0.001); similarly, patients in the repeat group had significant improvement in ROM and ASES score at 3 months and one-year after the procedure (p<0.001). Patients in the repeat group had had significantly more severely limited ROM (p<0.01) and decreased ASES score (p<0.001) before the procedure compared with those in the single group.ConclusionsA repeat MUC with corticosteroid and local anesthetic injection is a valuable option before proceeding to surgery for recurrence of idiopathic frozen shoulder. When there is severely limited ROM and decreased ASES score before the MUC, a repeat MUC may be necessary, which would require the patient’s informed consent.Trial registration Retrospectively registered.
The course and clinical impact of articular magnetic resonance imaging findings 6 months after shoulder manipulation under ultrasound-guided cervical nerve root block for frozen shoulder
