The Comparison Of Arthroscopic Release And Closed Manipulation In The Treatment Of Frozen Shoulder

Objective Compare the effect of shoulder arthroscopic release and closedmanipulation in the treatment of frozen shoulder in order to figure out a more effectivetreatment and provide the evidences for it.Methods①.Data collection: Analyse the clinical data of128patients from2010to2013with frozen shoulder retrospectively. Among them91cases are females and27casesare males with an average age from42to65and an average course of11months.Fifty-seven of them were given shoulder arthroscopic release while the other71weregiven closed manipulation.②.observation content: The American Shoulder and ElbowSurgeons(ASES)score and Visual Analogue Score(VAS) were used to evaluate theefficacy of the treatment before and after operation.Results①.All of the128patients recovered well without any surgical complicationsor adverse drug reaction. But one case of the arthroscopic group didn’t regain enoughrange of motion(ROM). At the mean time, two cases of the closed manipulation groupdidn’t regain enough ROM. Follow-up assessments were taken during the3months afteroperation.②.The VAS and ASES of the arthroscopic group before treatment are7.9±1.1points and51.6±6.2points. And those of the closed manipulation group are7.7±0.8pointsand51.6±6.2points. There is no significant difference between these two groups.③The48h post operation VAS and ASES of the arthroscopic group are6.3±0.6points and59.8±6.5points. And those of the closed manipulation group are4.2±0.6points and62.7±6.4points. The one-week post operation VAS and ASES of the arthroscopic groupare4.2±0.6points and59.8±6.5points. And those of the closed manipulation group are6.2±0.9points and62.7±6.4points. The one-month post operation VAS and ASES of thearthroscopic group are2.6±0.7points and83.6±5.1points. And those of the closedmanipulation group are4.7±1.1points and71.9±6.3points. Significant differences ofASES and VAS were seen48hours,1week and1month after operation in the same group from before.(P<0．05).And there are also significant differences of ASES and VAS48hours,1week and1month after operation between the two groups.Conclusion①.The effect of shoulder arthroscopic release is better than closedmanipulation both in the post-operation pain relief and improvement of glenohumeralROM.②, In addition, arthroscopic surgery can release the contracted capsule moreprecisely with less risk of surgical trauma, and complications.③. Moreover, arthroscopicrelease can recover the ROM of shoulder joint without destruct the tissues around thecapsule. And other intra-articular diseases can be found out at the same time. However, itrequires more costy facility and skilled surgeons to carry out shoulder arthroscopic surgery.With such conditions, the long term pain-relief and ROM recovery effect of shoulderarthroscopic release is better than closed manipulation.