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  • Title: Translational manipulation after failed arthroscopic capsular release for recalcitrant adhesive capsulitis: a case report.
    Author: Roubal PJ, Placzek J.
    Journal: J Manipulative Physiol Ther; 2008 Oct; 31(8):632-6. PubMed ID: 18984247.
    Abstract:
    OBJECTIVE: This article reports the use of translational manipulation after failed arthroscopic capsular release for adhesive capsulitis. CLINICAL FEATURES: The patient was a 40-year-old woman, insulin-dependent diabetic with the insidious onset of right shoulder adhesive capsulitis. The patient underwent physical therapy 3 times a week for 6 weeks with minimal changes in her range of motion or pain. After failing physical therapy, the patient had arthroscopic capsular release and long-lever arm rotational manipulation of the right shoulder. The patient participated in physical therapy again, failing to regain her range of motion. INTERVENTION AND OUTCOME: Subsequently, the patient underwent interscalene block and translational manipulation by the same therapist followed by physical therapy. The patient's range-of-motion measures, strength testing, pain scale measurements, and functional scoring were recorded throughout her rehabilitation. She returned 2 years postdischarge for the same tests and measurements. CONCLUSION: Adhesive capsulitis in association with diabetes mellitus poses a serious treatment dilemma. Arthroscopic release may have limited benefits secondary to limited release and/or postoperative pain limiting rehabilitation. Translational manipulation under interscalene block may be considered in this difficult treatment group.
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