متلازمة الكتف المتجمد غير المستجيبة للعلاج التحفظي

References

DOI: 10.1007/s43465-021-00351-3

• Invasive operative methods (manipulation or surgical release of capsule) to improve function in patients with primary FS are recommended only when an extended conservative treatment for a period of 6–9 months fails to provide significant relief to the patient.
• MUA is a method wherein fibrosed capsulo-ligament complex of shoulder, which is a hindrance in regaining ROM, is forcibly broken by manoeuvring the shoulder across the ROM under anaesthesia.
• Although all high-quality clinical studies have failed to reveal any major advantage of ACR over MUA; of late, ACR has emerged as 'preferred' surgical option for the treatment of refractory FS as ACR allows controlled and precise release of fibrosed capsule–ligament complex under vision avoiding the said complications of MUA under the same anaesthetic burden.
• Post MUA or ACR, authors prefer to inject 40 mg of Triamcinolone along with 10 ml of 0.25% Bupivacaine to minimise post-procedure inflammation and pain.
• Many studies have shown excellent short-, mid- and long-term results both in terms of lasting pain relief and ROM gains with ACR.
• Many studies have reported good to excellent long-term clinical outcome after MUA.