Shoulder adhesive capsulitis: manipulation and arthroscopic arthrolysis or intra-articular steroid injections?

The aim of this study was to compare shoulder manipulation and arthroscopic arthrolysis with glenohumeral steroid injections in patients affected by idiopathic adhesive shoulder capsulitis. In this prospective study we randomly assigned patients to enter group A (23 patients, shoulder manipulation and arthroscopic arthrolysis) and group B (21 patients, glenohumeral steroid injections). Patients were followed-up at three, six and 12 weeks, and at six and 12 months with the Constant and Murley, ASES, UCLA and SST evaluation scales. Moreover, passive forward flexion, abduction, and internal and external rotations were recorded. Range of motion showed satisfactory results in both groups at final follow-up: in group A the mean ABD increased from 60A degrees to 154A degrees, ER from 20A degrees to 40A degrees, and FF from 75A degrees to 174A degrees; in group B, ABD raised from 76A degrees to 145A degrees, ER from 20A degrees to 35A degrees, and FF from 115A degrees to 164A degrees. All the evaluation scales performed increased significantly at final follow-up in both groups. However, while patients of group A had already reached significant improvement at the six-week follow-up (p < 0.03), in group B this happened only at the 12 week follow-up (p < 0.03). Both types of treatment were effective in improving final range of motion; however, while patients of group A accomplished their goal by the six-week follow-up, in group B the same result was obtained at the 12-week follow-up.