Does capsular distension and a short period of counter-traction improve outcome following manipulation under anaesthesia for the treatment of primary adhesive capsulitis of the glenohumeral joint?

2021 ◽  
Author(s):  
Johan van der Stok ◽  
Michael Fitzsimons ◽  
Joseph M. Queally ◽  
Turlough O’Donnell
Keyword(s):  
Glenohumeral Joint ◽  
Adhesive Capsulitis ◽  
Improve Outcome ◽  
Short Period ◽  
Manipulation Under Anaesthesia

scholarly journals Hyperlipidemia Is a Risk Factor of Adhesive Capsulitis: Real-World Evidence Using the Taiwanese National Health Insurance Research Database

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712098680
Author(s):  
Jr-Yi Wang ◽  
Chen-Kun Liaw ◽  
Chi-Chang Huang ◽  
Tsan-Hon Liou ◽  
Hui-Wen Lin ◽  
...  
Keyword(s):  
Risk Factor ◽  
Health Insurance ◽  
Propensity Score ◽  
National Health Insurance ◽  
National Health ◽  
Glenohumeral Joint ◽  
Adhesive Capsulitis ◽  
Small Sample ◽  
Research Database ◽  
Statin Use

Background: Patients with adhesive capsulitis are evaluated for pain and progressive contracture of the glenohumeral joint. Whether endocrine, immune, or inflammatory processes are involved in its definite pathogenesis is still under debate. Some cross-sectional studies with a small sample size have noted that hyperlipidemia is a possible risk factor for frozen shoulders. Purpose/Hypothesis: The purpose was to conduct a longitudinal population-based study to investigate the risk of adhesive capsulitis among patients with hyperlipidemia. It was hypothesized that patients with hyperlipidemia would have a higher risk of adhesive capsulitis and that the use of statin drugs could reduce the rate. Study Design: Cohort study; Level of evidence, 3. Methods: Using data from the National Health Insurance Research Database (NHIRD) of Taiwan, the authors obtained the records of patients with hyperlipidemia who received a diagnosis between 2004 and 2005 and were followed up until the end of 2010. The control cohort comprised age- and sex-matched patients without hyperlipidemia. Propensity score matching was performed for the other comorbidities. A Cox multivariate proportional hazards model was applied to analyze the risk factors of adhesive capsulitis. The hazard ratio (HR) and adjusted HR were estimated between the study and control cohorts after adjustment for confounders. The effects of statin use on adhesive capsulitis risk were also analyzed. Results: The NHIRD records of 28,748 patients and 114,992 propensity score–matched controls were evaluated. A higher incidence rate of adhesive capsulitis was revealed in the hyperlipidemia cohort, with a crude HR of 1.70 (95% CI, 1.61-1.79; P < .001) and adjusted HR of 1.50 (95% CI, 1.41-1.59; P < .001). Patients with hyperlipidemia who used a statin still had higher crude and adjusted HRs compared with controls. Statin use did not exert protective effects on patients with hyperlipidemia. Conclusion: Patients with hyperlipidemia had a 1.5-fold higher risk of adhesive capsulitis than did healthy controls. Statin use did not provide protection against adhesive capsulitis in patients with hyperlipidemia.

Common upper limb musculoskeletal lesions

2018 ◽  
pp. 595-604
Author(s):  
Gavin Clunie ◽  
Nick Wilkinson ◽  
Elena Nikiphorou ◽  
Deepak R. Jadon
Keyword(s):  
Rotator Cuff ◽  
Upper Limb ◽  
Glenohumeral Joint ◽  
Tennis Elbow ◽  
Adhesive Capsulitis ◽  
Lateral Epicondylitis ◽  
Glenohumeral Instability ◽  
Suprascapular Notch ◽  
Long Head ◽  
Musculoskeletal Lesions

This chapter introduces readers to some common upper limb musculoskeletal lesions, including subacromial (shoulder) impingement syndrome, adhesive capsulitis, and lateral epicondylitis (tennis elbow). The epidemiology, aetiopathogenesis, clinical presentation, and management of these conditions are presented. Algorithms for their management are provided. Other disorders presenting with a subacromial impingement pattern of pain are detailed and optimal diagnostic imaging methods proposed. These include supraspinatus/cuff tendonitis, subacromial bursitis, rotator cuff tear, long head of biceps tendonitis, osteophyte impingement on the rotator cuff tendon, glenohumeral instability due to labral trauma (e.g. SLAP lesion), arthritis of the glenohumeral joint, enthesitis related to spondyloarthritis, and lesions at the suprascapular notch.

Reliability of stiffness measured in glenohumeral joint and its application to assess the effect of end-range mobilization in subjects with adhesive capsulitis

2008 ◽  
Vol 13 (4) ◽  
pp. 307-316 ◽  
Author(s):  
Hui-Ting Lin ◽  
Ar-Tyan Hsu ◽  
Kai-Nan An ◽  
Jia-rea Chang Chien ◽  
Ta-Shen Kuan ◽  
...  
Keyword(s):  
Glenohumeral Joint ◽  
Adhesive Capsulitis

scholarly journals Adhesive Capsulitis of the Shoulder. Is there Consensus Regarding the Treatment? A Comprehensive Review

2017 ◽  
Vol 11 (1) ◽  
pp. 65-76 ◽  
Author(s):  
Dimitrios Georgiannos ◽  
George Markopoulos ◽  
Eirini Devetzi ◽  
Ilias Bisbinas
Keyword(s):  
Conservative Management ◽  
Health Care Professionals ◽  
Adhesive Capsulitis ◽  
Suprascapular Nerve ◽  
Treatment Modalities ◽  
Published Evidence ◽  
Arthroscopic Capsular Release ◽  
Suprascapular Nerve Block ◽  
Manipulation Under Anaesthesia ◽  
Limiting Condition

Background:Adhesive capsulitis of the shoulder (ACS) is a common self-limiting condition characterized by disabling pain and restricted movements. Its pathophysiology is poorly understood, clinically it is characterized by stages of pain and stiffness, and finally often patients never recover fully. However, there is no consensus about available methods of treatment for ACS. The aims of this paper are to discuss and develop issues regarding approaches to management in ACS in the stages of it.Methods:A review of the literature was performed and guidelines for the treatment of that clinical entity for doctors and health care professionals are provided.Results:Anti-inflammatory medications, steroid and/or hyaluronate injections and physiotherapy is the mainstay of conservative management either alone in the first stages or in combination with other treatment modalities in the later stages. Next line of treatment, involving minor to moderate intervention, includes suprascapular nerve block, distension arthrography and manipulation under anaesthesia. In order to avoid complications of “blind intervention”, arthroscopic capsular release is gradually more commonly applied, and in recalcitrant severe cases open release is a useful option.Conclusion:Various modalities of conservative management and gradually more surgical release are applied. However, often clinicians choose on personal experience and training rather than on published evidence.

scholarly journals Contrast Dispersion Pattern and Efficacy of Corticosteroid at the Glenohumeral Joint in Adhesive Capsulitis

2015 ◽  
Vol 5;18 (5;9) ◽  
pp. E787-E794
Author(s):  
Sang Jun Kim
Keyword(s):  
Rating Scale ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Corticosteroid Injection ◽  
Adhesive Capsulitis ◽  
Numeric Rating Scale ◽  
Dispersion Pattern ◽  
Pathologic Findings ◽  
Pain Improvement ◽  
Numeric Rating

Background: Corticosteroid injection has a wide range of success in adhesive capsulitis but the reason for this has not yet been explained. We hypothesized that this difference might be due to the distribution of the corticosteroids injected into the joint cavity because particulate steroid deposits in the capsule and will not be moved over time by shoulder motion. Objectives: The purpose of this study is to determine whether the therapeutic efficacy of particulate corticosteroid injection into the glenohumeral joint differs according to the dispersion pattern. Study Design: Prospective evaluation. Setting: Outpatient clinics at a tertiary university hospital Methods: Seventy-two patients diagnosed as having adhesive capsulitis received a corticosteroid injection at the glenohumeral joint. The posterior capsule and the subscapular bursa were selected as dispersion sites and the dispersion of contrast dye was expressed as a ratio (%). Two weeks and 3 months after the injection clinical improvement (“not improved,” “slightly improved,” “much improved”), numeric rating scale (NRS), and passive range of motions (PROM) were evaluated. The dispersion of the contrast dye was compared according to the clinical improvements by an analysis of variance test. Pearson correlation test was done to find the relationship between PROM and the dispersion and between change of NRS and the dispersion. Results: The distribution in the subscapular area was 30.0% in the “much improved” group, 22.0% in the “slightly improved” group, and 37.1% in the “no improvement” group which was not significantly different (P = 0.179). Correlations between changes of NRS and the dye distribution were not statistically significant (P = 0.429 at 2 weeks and P = 0.629 at 3 months). The change of passive external rotation 3 months after the injection was significantly correlated with the dye distribution (P = 0.035). Limitations: Because of diverse pathologic findings in adhesive capsulitis, further studies will be needed to address the effect of the dye distribution on the pain improvement according to pathologic findings revealed by magnetic resonance imaging (MRI). Conclusion: External rotation of the shoulder in adhesive capsulitis has greater improvement as the corticosteroid solutions injected into the glenohumeral joint are increasingly dispersed to the subscapularis area. However, this does not affect the pain improvement after the injection. Key words: Adhesive capsulitis, dispersion, contrast dye, subscapularis, glenohumeral joint, corticosteroid, range of motion, numeric rating scale

Streptococcus gordonii septic arthritis of the glenohumeral joint following deltoid intramuscular vaccination

2021 ◽  
Vol 14 (5) ◽  
pp. e243066
Author(s):  
Robert Costigan Flowers ◽  
Beatriz Rivera Rodriguez ◽  
Kelly Corbitt
Keyword(s):  
Staphylococcus Aureus ◽  
Physical Therapy ◽  
Septic Arthritis ◽  
Inflammatory Markers ◽  
Glenohumeral Joint ◽  
Adhesive Capsulitis ◽  
Left Shoulder ◽  
Streptococcus Gordonii ◽  
Viridans Group Streptococci ◽  
Post Infectious

A 68-year-old woman presented for left shoulder pain, decreased range of motion (ROM) and fever 7 days following COVID-19 vaccination. Investigations showed a tender left deltoid mass, decreased shoulder ROM and elevated inflammatory markers. MRI demonstrated a large glenohumeral effusion with synovitis, and arthrocentesis confirmed septic arthritis (SA). She required subtotal bursectomy. Intraoperative joint cultures grew Streptococcus gordonii. She completed 6 weeks of antibiotics and is undergoing physical therapy for post-infectious adhesive capsulitis. SA is most commonly due to Staphylococcus aureus and β-haemolytic streptococci, and rarely due to viridans group streptococci including S. gordonii. To avoid inadvertent injection into the glenohumeral joint, vaccination should be performed posteriorly and inferiorly into the deltoid musculature. Progressive pain, fever or decreased passive ROM following vaccination should raise concern for SA. Given its rarity, however, concern for secondary SA should not affect the general population’s consideration for vaccination.

MANAGEMENT OF ADHESIVE CAPSULITIS OF SHOULDER JOINT BY SINGLE PLATELET RICH PLASMA INJECTION

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Himanshu Suman ◽  
Puneet Kumar Acharya ◽  
Jyoti Krishna ◽  
Yash Sharma ◽  
Oaj Dosaj
Keyword(s):  
Glenohumeral Joint ◽  
Platelet Rich Plasma ◽  
Adhesive Capsulitis ◽  
Cost Effective ◽  
College Hospital ◽  
Duration Of Symptoms ◽  
Medical College ◽  
Vas Score ◽  
Plasma Injection ◽  
Hospital Patients

Introduction: Adhesive capsulitis is a painful impairment characterized by the restriction of movement of shoulder due to the adhesions across the glenohumeral joint, injection of platelet-rich plasma is effective treatment to reduce the pain and restore the movement of shoulder. Aim: To assess the effectiveness single PRP injection in management of adhesive capsulitis. Material and Methods: This study enrolled 12 patients experiencing the shoulder pain for at least 3 months and attending our medical college hospital. Patients with adhesive capsulitis were given a single injection of PRP (4 ml) and followed up for 12 weeks, VAS scores and Disability Index scores were recorded and compared with the baseline scores. Result:  In present study majority of patients were females with mean duration of symptoms was 3 months. Post PRP treatment all the patients have shown significant improvement on pains VAS score, movement VAS score on 2nd, 6th, and 12th weeks follow up. Conclusion:  Present studies conclude that the AC is more prevalent among females which can be treated effectively with PRP technique. PRP as is a simple, safe and cost-effective management of AC without any adverse effects. Keywords: Adhesive Capsulitis, Platelet-Rich Plasma, Corticosteroid, Intra-articular

scholarly journals End-Range Mobilization Techniques in Adhesive Capsulitis of the Shoulder Joint: A Multiple-Subject Case Report

2000 ◽  
Vol 80 (12) ◽  
pp. 1204-1213 ◽  
Author(s):  
Henricus M Vermeulen ◽  
Wim R Obermann ◽  
Bart J Burger ◽  
Gea J Kok ◽  
Piet M Rozing ◽  
...  
Keyword(s):  
Case Report ◽  
Range Of Motion ◽  
Sagittal Plane ◽  
Glenohumeral Joint ◽  
Adhesive Capsulitis ◽  
Plain Radiograph ◽  
Shoulder Function ◽  
Joint Mobility ◽  
Lateral Rotation

Abstract Background and Purpose. The purpose of this case report is to describe the use of end-range mobilization techniques in the management of patients with adhesive capsulitis. Case Description. Four men and 3 women (mean age=50.2 years, SD=6.0, range=41–65) with adhesive capsulitis of the glenohumeral joint (mean disease duration=8.4 months, SD=3.3, range= 3–12) were treated with end-range mobilization techniques, twice a week for 3 months. Indexes of pain, joint mobility, and function were measured by the same observer before treatment, after 3 months of treatment, and at the time of a 9-month follow-up. In addition, arthrographic assessment of joint capacity (ie, the amount of fluid the joint can contain) and measurement of range of motion of glenohumeral abduction on a plain radiograph were conducted initially and after 3 months of treatment. Outcomes. After 3 months of treatment, there were increases in active range of motion. Mean abduction increased from 91 degrees (SD=16, range=70–120) to 151 degrees (SD=22, range=110–170), mean flexion in the sagittal plane increased from 113 degrees (SD=17, range=90–145) to 147 degrees (SD=18, range=115–175), and mean lateral rotation increased from 13 degrees (SD=13, range=0–40) to 31 degrees (SD=11, range=15–50). There were also increases in passive range of motion: Mean abduction increased from 96 degrees (SD=18, range=70–125) to 159 degrees (SD=24, range 110–180), mean flexion in the sagittal plane increased from 120 degrees (SD=16, range=95–145) to 154 degrees (SD=19, range=120–180), and mean lateral rotation increased from 21 degrees (SD=11, range=10–45) to 41 degrees (SD=8, range=35–55). The mean capacity of the glenohumeral joint capsule (its ability to contain fluid) increased from 10 cc (SD=3, range=6–15) to 15 cc (SD=3, range=10–20). Four patients rated their improvement in shoulder function as excellent, 2 patients rated it as good, and 1 patient rated it as moderate. All patients maintained their gain in joint mobility at the 9-month follow-up. Discussion. There seems to be a role for intensive mobilization techniques in the treatment of adhesive capsulitis. Controlled studies regarding the effectiveness of end-range mobilization techniques in the treatment of adhesive capsulitis are warranted.

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