Manipulation Under Anesthesia with Intra-Articular Steroid Injection versus Manipulation under Anesthesia in Idiopathic Adhesive Capsulitis of the Shoulder in terms of Functional Outcome

Abstract

Objective: To compare the outcome between manipulation under anaesthesia with intra-articular steroid injection in patients with shoulder adhesive capsulitis.

Study Design: Retrospective longitudinal study

Place and Duration of Study: Ziauddin Hospital, Karachi Pakistan, from Sep 2019 to Feb 2020.

Methodology: A total of 70 patients diagnosed with primary ACS were distributed into two groups, i.e., Group-M (35 in manipulation under anaesthesia only) and Group-MI (35 in manipulation under anaesthesia with an intra-articular steroid injection). All patients were assessed for shoulder pain and disability index along with the pain severity on the visual analogue scale at each subsequent visit on the first week, 1st, third and sixth months after the intervention.

Results: The results indicated a significant time effect (p=0.001) in both groups. The mean shoulder pain, disability index and pain on the visual analogue scale were lesser in the MI-Group than in the M-Group. Further, we found a statistically significant difference in mean shoulder pain (p=0.001) and disability index (p=0.016) between groups at six months.

Conclusion: In the initial post-procedure period and over six months of follow-up, MI showed improved outcomes than M. These patients require additional counselling and motivation for long-term physical therapy programs even after intervention for optimal results.
Keywords: Adhesive capsulitis of the shoulder, Intra-articular steroid injection, Manipulation under anaesthesia