Adhesive Capsulitis of the Shoulder: Comparison Between Conservative Treatment Methods
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Published:
Dec 31, 2022
Keywords:
Adhesive capsulitis, conservative treatment
Main Article Content
Abstract
Objective: To evaluate the functional outcomes of three different conservative treatment protocols in patients with adhesive capsulitis of the shoulder.
Materials and Methods: Reviews of medical records were carried out on patients treated at the institution for adhesive capsulitis in the period between January 2016 and January 2019. 3 different treatment protocols were compared. Group 1; Suprascapular nerve block (SSNB) with local anesthetic and corticosteroid, analgesics, and physiotherapy after pain reduction. Group 2: SSNB with local anesthetic without corticosteroids, analgesics, and physiotherapy, and group 3: analgesics and physiotherapy,without SSNB. The functional outcomes were determined with the ASES scale and the subjective results were assessed with the SSV.
Results: A total of 46 patients treated for adhesive capsulitis were divided into 3 groups. Group 3 presented a higher mean number of physiotherapy sessions (30.31±21.07). Group 2 had the highest mean number of SSN blocks (3.27±1.22). The results of the functional scores were: group 1 (15 patients): mean ASES 84 and mean SSV 84; group 2 (15 patients): mean ASES 93.40 and mean SSV 91.67; group 3 (16 patients): mean ASES 79.4 and mean SSV 80.63.
Conclusion: The various forms of conservative treatment for adhesive capsulitis achieve excellent outcomes. Analgesia through serial blocks of the suprascapular nerve with an anesthetic and corticosteroid achieved better functional and subjective outcomes and decreased the need to administer analgesics and physiotherapy sessions (group 1).Level of Evidence: IV
Materials and Methods: Reviews of medical records were carried out on patients treated at the institution for adhesive capsulitis in the period between January 2016 and January 2019. 3 different treatment protocols were compared. Group 1; Suprascapular nerve block (SSNB) with local anesthetic and corticosteroid, analgesics, and physiotherapy after pain reduction. Group 2: SSNB with local anesthetic without corticosteroids, analgesics, and physiotherapy, and group 3: analgesics and physiotherapy,without SSNB. The functional outcomes were determined with the ASES scale and the subjective results were assessed with the SSV.
Results: A total of 46 patients treated for adhesive capsulitis were divided into 3 groups. Group 3 presented a higher mean number of physiotherapy sessions (30.31±21.07). Group 2 had the highest mean number of SSN blocks (3.27±1.22). The results of the functional scores were: group 1 (15 patients): mean ASES 84 and mean SSV 84; group 2 (15 patients): mean ASES 93.40 and mean SSV 91.67; group 3 (16 patients): mean ASES 79.4 and mean SSV 80.63.
Conclusion: The various forms of conservative treatment for adhesive capsulitis achieve excellent outcomes. Analgesia through serial blocks of the suprascapular nerve with an anesthetic and corticosteroid achieved better functional and subjective outcomes and decreased the need to administer analgesics and physiotherapy sessions (group 1).Level of Evidence: IV
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Bonadiman, J. A., Esteve, N., Triervelier Paiva, F. R., Faiad Piluski, P. C., Castillo Rodriguez, C. H., & Lech, O. (2022). Adhesive Capsulitis of the Shoulder: Comparison Between Conservative Treatment Methods. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 87(6), 781-788. https://doi.org/10.15417/issn.1852-7434.2022.87.6.1625
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Clinical Research
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References
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capsulite adesiva com bloqueios seriados do nervo supra-escapular. Rev Bras Ortop 2006;41(7):245-52. Disponible en: https://cdn.publisher.gn1.link/rbo.org.br/pdf/41-6/2006_jul_08.pdf
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outpatient clinic: An epidemiological study. Acta Ortop Bras 2017;25(3):78-80.
https://doi.org/10.1590/1413-785220172503170849
4. Miyazaki AN, Santos PD, Silva LA, Sella GdV, Carrenho L, Checchia SL. Clinical evaluation of arthroscopic
treatment of shoulder adhesive capsulitis. Rev Bras Ortop (English ed.) 2017;52(1):61-8.
https://doi.org/10.1016/j.rboe.2016.12.004
5. Endres NK, ElHassan B, Higgins LD, Warner JJP. The stiff shoulder. En: Rockwood and Matsen´s The shoulder. 4th ed. Philadelphia: Saunders; 2009:1405-1435. https://doi.org/10.1016/B978-1-4160-3427-8.50035-0
6. Georgiannos D, Markopoulos G, Devetzi E, Bisbinas I. Adhesive capsulitis of the shoulder. Is there consensus
regarding the treatment? A comprehensive review. Open Orthop J 2017;11:65-76.
https://doi.org/10.2174/1874325001711010065
7. Neviaser JS. Adhesive capsulitis and the stiff and painful shoulder. Orthop Clin North Am 1980;11(2):327-31.
https://doi.org/10.1016/S0030-5898(20)31482-6
8. Grey R. The natural history of ‘idiopathic’ frozen shoulder. J Bone Joint Surg Am 1978;60(4):564.
https://doi.org/10.2106/00004623-197860040-00029
9. Reeves B. The natural history of the frozen shoulder syndrome. Scand J Rheumatol 1975;4(4):193-6.
https://doi.org/10.3109/03009747509165255
10. Ramirez J. Adhesive capsulitis: Diagnosis and management. Am Fam Physician 2019;99(5):297-300.
PMID: 30811157
11. Lech O, Sudbrack G, Valenzuela CN. Capsulite adesiva (“ombro congelado”). abordagem multidisciplinar. Rev Bras Ortop 1993;24:617-24. Disponible en: https://rbo.org.br/detalhes/951/pt-BR
12. Michener LA, McClure PW, Sennett BJ. American shoulder and elbow surgeons standardized shoulder assessment form, patient self-report section: Reliability, validity, and responsiveness. J Shoulder Elbow Surg 2002;11(6):587-94. https://doi.org/10.1067/mse.2002.127096
13. Gilbart MK, Gerber C. Comparison of the subjective shoulder value and the constant score. J Shoulder Elbow Surg 2007;16(6):717-21. https://doi.org/10.1016/j.jse.2007.02.123
14. Dangoisse MJ, Wilson DJ, Glynn CJ. MRI and clinical study of an easy and safe technique of suprascapular nerve blockade. Acta Anaesthesiol Belg 1994;45(2):49-54. PMID: 7976163
15. Morettin PA, Bussab WO. Estatística básica, 7ª. ed. São Paulo: Editora Saraiva; 2011.
16. David J. Handbook of parametric and nonparametric statistical procedures. 3rd ed. New York: Chapman & Hall/CRC; 2004.
17. Cohen C, Tortato S, Bento Souza Silva O, Ferreira Leal M, Ejnisman B, Faloppa F. Association between frozen
shoulder and thyroid diseases: Strengthening the evidences. Rev Bras Ortop 2020;55(4):483-9.
https://doi.org/10.1055/s-0039-3402476
18. Pardini A, Godinho G. Capsulite adesiva: Tratamento conservador. En: Pardini A. Clínica ortopédica. Rio de
Janeiro: Medsi; 2000:197-202.
19. Ranalletta M, Rossi LA, Bongiovanni SL, Tanoira I, Elizondo CM, Maignon GD. Corticosteroid injections
accelerate pain relief and recovery of function compared with oral NSAIDs in patients with adhesive capsulitis: A
randomized controlled trial. Am J Sports Med 2016;44(2):474-81. https://doi.org/10.1177/0363546515616238
20. Chang KV, Hung CY, Wu WT, Han DS, Yang RS, Lin CP. Comparison of the effectiveness of suprascapular nerve
block with physical therapy, placebo, and intra-articular injection in management of chronic shoulder pain: A metaanalysis of randomized controlled trials. Arch Phys Med Rehabil 2016;97(8):1366-80.
https://doi.org/10.1016/j.apmr.2015.11.009
21. Yip M, Francis A, Roberts T, Rokito A, Zuckerman JD, Virk MS. Treatment of adhesive capsulitis of the shoulder: A critical analysis review. JBJS Rev 2018;6(6):e5. https://doi.org/10.2106/JBJS.RVW.17.00165
22. Lafosse L, Boyle S, Kordasiewicz B, Guttierez-Arramberi M, Fritsch B, Meller R. Arthroscopic arthrolysis for
recalcitrant frozen shoulder: A lateral approach. Arthroscopy 2012;28(7):916-23. https://doi.org/10.1016/j.arthro.2011.12.014
23. Redler LH, Dennis ER. Treatment of adhesive capsulitis of the shoulder. J Am Acad Orthop Surg
2019;27(12):e544-e554. https://doi.org/10.5435/JAAOS-D-17-00606
https://doi.org/10.1016/j.jse.2010.07.008
2. Checchia SL, Fregoneze M, Miyazaki AN, Doneux Santos P, Andrade da Silva L, Ossada A, et al. Tratamento da
capsulite adesiva com bloqueios seriados do nervo supra-escapular. Rev Bras Ortop 2006;41(7):245-52. Disponible en: https://cdn.publisher.gn1.link/rbo.org.br/pdf/41-6/2006_jul_08.pdf
3. Malavolta EA, Gracitelli ME, Assunção JH, Pinto GM, Silveira AZ, Ferreira Neto A. Shoulder disorders in an
outpatient clinic: An epidemiological study. Acta Ortop Bras 2017;25(3):78-80.
https://doi.org/10.1590/1413-785220172503170849
4. Miyazaki AN, Santos PD, Silva LA, Sella GdV, Carrenho L, Checchia SL. Clinical evaluation of arthroscopic
treatment of shoulder adhesive capsulitis. Rev Bras Ortop (English ed.) 2017;52(1):61-8.
https://doi.org/10.1016/j.rboe.2016.12.004
5. Endres NK, ElHassan B, Higgins LD, Warner JJP. The stiff shoulder. En: Rockwood and Matsen´s The shoulder. 4th ed. Philadelphia: Saunders; 2009:1405-1435. https://doi.org/10.1016/B978-1-4160-3427-8.50035-0
6. Georgiannos D, Markopoulos G, Devetzi E, Bisbinas I. Adhesive capsulitis of the shoulder. Is there consensus
regarding the treatment? A comprehensive review. Open Orthop J 2017;11:65-76.
https://doi.org/10.2174/1874325001711010065
7. Neviaser JS. Adhesive capsulitis and the stiff and painful shoulder. Orthop Clin North Am 1980;11(2):327-31.
https://doi.org/10.1016/S0030-5898(20)31482-6
8. Grey R. The natural history of ‘idiopathic’ frozen shoulder. J Bone Joint Surg Am 1978;60(4):564.
https://doi.org/10.2106/00004623-197860040-00029
9. Reeves B. The natural history of the frozen shoulder syndrome. Scand J Rheumatol 1975;4(4):193-6.
https://doi.org/10.3109/03009747509165255
10. Ramirez J. Adhesive capsulitis: Diagnosis and management. Am Fam Physician 2019;99(5):297-300.
PMID: 30811157
11. Lech O, Sudbrack G, Valenzuela CN. Capsulite adesiva (“ombro congelado”). abordagem multidisciplinar. Rev Bras Ortop 1993;24:617-24. Disponible en: https://rbo.org.br/detalhes/951/pt-BR
12. Michener LA, McClure PW, Sennett BJ. American shoulder and elbow surgeons standardized shoulder assessment form, patient self-report section: Reliability, validity, and responsiveness. J Shoulder Elbow Surg 2002;11(6):587-94. https://doi.org/10.1067/mse.2002.127096
13. Gilbart MK, Gerber C. Comparison of the subjective shoulder value and the constant score. J Shoulder Elbow Surg 2007;16(6):717-21. https://doi.org/10.1016/j.jse.2007.02.123
14. Dangoisse MJ, Wilson DJ, Glynn CJ. MRI and clinical study of an easy and safe technique of suprascapular nerve blockade. Acta Anaesthesiol Belg 1994;45(2):49-54. PMID: 7976163
15. Morettin PA, Bussab WO. Estatística básica, 7ª. ed. São Paulo: Editora Saraiva; 2011.
16. David J. Handbook of parametric and nonparametric statistical procedures. 3rd ed. New York: Chapman & Hall/CRC; 2004.
17. Cohen C, Tortato S, Bento Souza Silva O, Ferreira Leal M, Ejnisman B, Faloppa F. Association between frozen
shoulder and thyroid diseases: Strengthening the evidences. Rev Bras Ortop 2020;55(4):483-9.
https://doi.org/10.1055/s-0039-3402476
18. Pardini A, Godinho G. Capsulite adesiva: Tratamento conservador. En: Pardini A. Clínica ortopédica. Rio de
Janeiro: Medsi; 2000:197-202.
19. Ranalletta M, Rossi LA, Bongiovanni SL, Tanoira I, Elizondo CM, Maignon GD. Corticosteroid injections
accelerate pain relief and recovery of function compared with oral NSAIDs in patients with adhesive capsulitis: A
randomized controlled trial. Am J Sports Med 2016;44(2):474-81. https://doi.org/10.1177/0363546515616238
20. Chang KV, Hung CY, Wu WT, Han DS, Yang RS, Lin CP. Comparison of the effectiveness of suprascapular nerve
block with physical therapy, placebo, and intra-articular injection in management of chronic shoulder pain: A metaanalysis of randomized controlled trials. Arch Phys Med Rehabil 2016;97(8):1366-80.
https://doi.org/10.1016/j.apmr.2015.11.009
21. Yip M, Francis A, Roberts T, Rokito A, Zuckerman JD, Virk MS. Treatment of adhesive capsulitis of the shoulder: A critical analysis review. JBJS Rev 2018;6(6):e5. https://doi.org/10.2106/JBJS.RVW.17.00165
22. Lafosse L, Boyle S, Kordasiewicz B, Guttierez-Arramberi M, Fritsch B, Meller R. Arthroscopic arthrolysis for
recalcitrant frozen shoulder: A lateral approach. Arthroscopy 2012;28(7):916-23. https://doi.org/10.1016/j.arthro.2011.12.014
23. Redler LH, Dennis ER. Treatment of adhesive capsulitis of the shoulder. J Am Acad Orthop Surg
2019;27(12):e544-e554. https://doi.org/10.5435/JAAOS-D-17-00606