Abstract
Two hundred patients with Adhesive Capsulitis according to Codman’s criteria were treated with manipulation under anaesthetic and hydraulic distension by the senior author. The procedure and subsequent rehabilitation was uniform for all patients. The average age at time of procedure was sixty years (range 36–91 years). Follow-up was performed using a self-assessment booklet which we devised to examine outcome in the following areas: Pain Visual Analogue Score, Ten Activities of Daily Living, Ability to Sleep & Lie on Affected Shoulder, Range of Motion and overall satisfaction. The average length of follow-up was sixty-two months (range 12–125 months). One hundred and forty-five patients were available for follow-up and completed the assessment correctly.
Results: There were no operative complications in this group. Pain was significantly decreased from a mean pre-operative pain visual analogue score of 7.9 to 1.4 post-operatively. Shoulder pain causing difficulty sleeping was reduced from 85% of patients pre-operatively to 15% post-operatively. Range of motion was assessed in comparison to pre-operative values of the affected side and current values of the unaffected side. Regarding patient satisfaction 90% of patients were improved post-operatively, 7.5% unchanged and 1.5% felt that their symptoms were worse following the procedure. The procedure was well tolerated and 97% of patients would have the procedure again. Patients who had the procedure within nine months following onset of symptoms had better long-term range of motion and functional outcome than those who had a greater delay in treatment. Our results indicate manipulation and hydraulic distension is a safe effective treatment for adhesive capsulitis and that a more favourable outcome is achieved if it is performed at an early stage.
The abstracts were prepared by Mr Ray Moran. Correspondence should be addressed to him at Irish Orthopaedic Associaton, Secretariat, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11.
