Management of adults with primary frozen shoulder in secondary care (UK FROST): a multicentre, pragmatic, three-arm, superiority randomised clinical trial

In this study of patients referred to secondary care for management (n=503), neither manipulation under anaesthesia nor arthroscopic capsular release met the criteria for superiority to early structured physiotherapy plus steroid injection.

SPS commentary:

The authors note that arthroscopic capsular release was associated with 8 serious adverse events and so appears to carry the highest risk. Manipulation under anaesthesia had the highest probability of being cost-effective at a willingness-to-pay threshold of £20,000 per quality-adjusted life-year.

Source:

The Lancet