AbstractsMedical & Health Science

The long-term outcome of frozen shoulder

by Heidi Anita Vastamäki




Institution: University of Helsinki
Department: Institute of Clinical Medicine, Ortopedia; Tieteellinen tutkimus Orton, Helsinki ja Sairaala Orton, Helsinki.
Year: 2015
Keywords: lääketiede
Record ID: 1131858
Full text PDF: http://hdl.handle.net/10138/154516


Abstract

ABSTRACT Vastamäki, Heidi Anita The long-term outcome of frozen shoulder Helsinki: University of Helsinki, 2015, 77 p. Publications of the ORTON Research Institute, A:39 The purpose of the current study was to assess and report the long-term outcome of frozen shoulder. The 234 patients with 257 frozen shoulders were clinically followed up for a mean 9.7 years (range, 2-30). The study includes five peer-reviewed articles. The specific aims of this project were to study: 1) the long-term outcome of the natural course of idiopathic frozen shoulder, 2) the very long-term outcome of manipulation under anesthesia (MUA), 3) the incidence and long-term outcome of postoperative frozen shoulder, 4) any influence of timing on the outcome of MUA, and 5) the long-term outcome of diabetic frozen shoulder. In general, patients with frozen shoulder recovered spontaneously over a mean duration of 15 months. After 9 year follow-up, 94% of shoulders showed a range of motion (ROM) similar to that of the contralateral, non-affected shoulder; 51% were totally pain-free, and 43% had pain ≤3/10 on the Visual Analogue Scale (VAS). In the long-term follow-up, diabetic patients shoulder ROM remained inferior to that of non-diabetic individuals. However, diabetic individuals frozen shoulders recovered to the patients own contralateral level. The very long-term outcome of manipulation under anesthesia was slightly inferior to the outcome of spontaneous recovery i.e. the natural course. After a mean 23 years follow-up of MUA, 47% of the shoulders had no pain at all. Even though ROM deteriorated between the last two follow-ups (7 vs. 23 years after MUA) the once-manipulated shoulder did reach the ROM level of the contralateral shoulder. Timing of MUA was statistically significantly associated with the outcome after manipulation of the idiopathic frozen shoulder. Optimal timing for MUA may be between 6 and 9 months from the beginning of symptoms. However, this finding may not be clinically significant. Concerning postoperative frozen shoulder after an open rotator cuff repair (RCR), the incidence was 20%. Compared to patients with no postoperative stiffness in their shoulders, the delay to postoperative healing was 3-6 months. The external rotation resolved first. One year after the surgery, the abduction and the flexion corresponded to that of the control patients shoulders. Patient age during RCR and the condition of the biceps tendon were related to the postoperative stiffness. In conclusion, the long-term outcome of frozen shoulder is good. TIIVISTELMÄ Vastamäki, Heidi Anita The long-term outcome of frozen shoulder Jäätynyt olkanivel on työikäisten yleisin ei-traumaattisen, pitkäaikaisen olkakivun ja olkanivelen liikerajoituksen aiheuttaja. Ihmisen normaalisti liikkuvin nivel jäykistyy niin, että liikkeet etu- ja sivusuuntiin sekä ulko- ja sisäkiertoon alenevat huomattavasti, jopa lähes kokonaan. Tämä aiheuttaa suurta haittaa käden ja yläraajan käytölle, kun kättä ei juuri saa nostettua vaakatasoa ylemmäs. Päivittäinen…