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Frozen shoulder
This document discusses frozen shoulder, also known as adhesive capsulitis. It begins by describing the pathology as similar to Dupuytren's contracture, involving fibroblastic proliferation. Risk factors include diabetes and Dupuytren's contracture. Presentation involves pain with passive external rotation. Management options discussed include non-operative treatments like steroid injections, hydrodilation, laser therapy, and oral steroids, as well as physiotherapy. Hydrodilation provides high patient satisfaction but availability and pain are issues. While most cases are treated non-operatively, around 10% may require arthroscopic capsular release surgery.
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Frozen shoulder
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- 2. Frozen shoulder • Adhesivecapsulitis • Pathology • similar to dupuytren’s • fibroblastic proliferation
- 3. Associations • Diabetes • Dupuytren’scontracture
- 4. Presentation • The Story •The examination • Screening test; Passive External Rotation
- 5. Natural history • 3phases- • Freezing • Frozen • Thawing
- 6. Investigations • XRAYS -to Exclude other mimicking conditions • THIS is a clinical diagnosis
- 7. Differentials • Sudden onsetsevere pain • Adhesive capsulitis • Calcific tendonitis • PT syndrome • Loss of ER • Adhesive capsulitis • OA • Locked Post dislocation
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- 9. Non operative mgx •Steroid: good for Pain not ROM • Hydrodilation: moderate ST relief- High patient satisfaction • Laser: Strong evidence • Oral steroids: short term moderate effect • SS nerve block: Pain reliefClin J Sport Med. 2012 Mar;22(2):168-9. The effectiveness of nonoperative treatment for frozen shoulder: a systematic review. Tashjian RZ.
- 10. Physiotherapy • + Safe •- May be too painful to be effective
- 11. Hydrodilatation • + Highpatient satisfaction • - Availability, pain
- 12. Operative treatment • 89.5%can be treated non-operatively • 10% pts’ needed release at 12 months from the onset of symptoms J Shoulder Elbow Surg. 2007 Sep-Oct;16(5):569-73. Epub 2007 May 24. Nonoperative management of idiopathic adhesive capsulitis. Levine WN, Kashyap CP, Bak SF, Ahmad CS, Blaine TA, Bigliani LU.
- 13. MUA • + Technicallyeasy • - Risk of fractures
- 14. A’scopic capsular release • +Precise and safe in the right setup • - Surgical risks
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