Featured ArticleNonoperative management of adhesive capsulitis of the shoulder: Oral cortisone application versus intra-articular cortisone injections
Section snippets
Material and methods
This study was approved by the scientific coordinator and the head of the department of Saarland University, Department of Orthopaedic Surgery, Homburg, Germany.
From 2005 to 2007, 45 patients with idiopathic stage II capsulitis of the shoulder were treated in our shoulder service.31 Patients with surgery of the affected shoulder, insulin-dependent diabetes mellitus, osteoarthritis, or other contraindications against cortisone were excluded. The remaining 40 patients were randomized, and 20 were
Shoulder scores
At the beginning of the treatment, the mean CM score was 18.9±8 points. Significant improvements were found after 4 weeks, with a mean CM score of 33.4±14.2 points (P < .0001). Scores were 45.1±16.9 after 8 weeks (P < .0001), 50.3±18.7 at 3 months (P < .0001), and 55.4±17.7 at 6 months (P < .0001). At the final follow-up after 1 year, the mean CM score was 62.7±16 points (P < .0001).
The SST results increased from 1.5±1.6 before treatment to 3.5±2.8 points at 4 weeks follow-up (P=.001), to
Discussion
Adhesive capsulitis of the shoulder remains a common disease with an uncertain pathogenesis.8, 19, 39 The clinical findings and macroscopic features support the pathologic findings of both inflammation and fibrosis.19
Approximately 70% to 90% of patients with stiff shoulders respond well to nonsurgical intervention.16, 24 Significant improvement in shoulder function is reported after physical therapy alone.18, 25 However, Rizk et al33 noted that only 60% of their patients treated with physical
Disclaimer
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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