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. 2015 Feb 5;4(4):420–424.

Table 3.

Factors influencing the approach to operative and non-operative management for the stiffness predominant phase of frozen shoulder.

Issue Respondents Expanded Comments
Diabetes 20 Surgery more likely/earlier (11); More aggressive approach (4); Arthroscopic arthrolysis more likely (3)
Chronicity 9 Surgery more likely/earlier (5)
Degree of stiffness 9 Arthroscopic release in severe stiffness (4); Other response: MUA is first choice for severe stiffness; poor results with hydro-dilatation in severe stiffness; MUA plus steroid injection in severe early phase stiffness.
Conservative management failure 9 Surgery more likely/earlier
Functional loss 8 Surgery more likely/earlier (4)
Patient led decision process 7 Discussion of disease course, activities of daily living/requirements, risks, benefits and success rate of intervention (6)
Underlying cause 4 MUA contraindicated in osteoporosis
Recurrence 3 MUA for early recurrence following arthroscopic release; More aggressive approach
Bilateral disease 2 More aggressive approach; contralateral disease requires surgery
Other responses MUA if resistant to distension; open arthrolysis used for secondary revision only; Capsular distension if general anaesthetic contraindicated; all patients excluding diabetics are treated by supervised neglect; MUA for uncomplicated Frozen Shoulder; previous dislocation then avoid MUA. If anaesthetic issues more likely to use MUA.

Numbers in brackets corresponds to the number of respondents expanding on the issue, MUA Manipulation Under Anaesthesia.