Yao Shiyi, Li Gen, Zhou Qiulun, Yang Renhao, Li Renxuan, Xu Yang, Zhang Yin, Wang Lei
Department of Orthopedics, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China.
Department of Clinical Data Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, PR China.
JSES Rev Rep Tech. 2025 Mar 23;5(3):413-422. doi: 10.1016/j.xrrt.2025.02.008. eCollection 2025 Aug.
Manipulation under anesthesia (MUA), combined with ultrasound-guided platelet-rich plasma injection, is expected to yield favorable functional outcomes in cases of shoulder stiffness concomitant with rotator cuff injury (RCI). Little has been reported on the efficacy of MUA with ultrasound-guided platelet-rich plasma injection for shoulder stiffness concomitant with RCI.
Beginning from August 2023, 30 patients with shoulder stiffness accompanied by RCI were enrolled in the study. All participants underwent MUA, accompanied by ultrasound-guided platelet-rich plasma injection at our institution. We collected and evaluated demographic data for each subject, as well as their range of motion (ROM), visual analog scale pain scores, Constant-Murley Scores, Western Ontario Rotator Cuff Index, and magnetic resonance imaging images. These assessments were conducted before the operation and at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months postoperation.
All patients exhibited a significantly improved ROM following the operation: forward flexion increased from 58.70° ± 6.01° to 154° ± 3.59° ( < .05); abduction improved from 58.20° ± 6.88° to 126° ± 3.04° ( < .05); external rotation progressed from grade 1-2 to grade 3-4; internal rotation advanced from grade 1-2 to grade 4-5. Patients aged 51-60 experienced the most significant improvement in forward flexion, while those younger than 40 showed the greatest enhancement in abduction. The mean visual analog scale score at rest was 1.89, indicating a significant improvement from preoperative levels (8.07) ( < .05). A significant difference was observed in the Constant-Murley Score and the Western Ontario Rotator Cuff Index pre and postoperation, with scores changing from 35.80 ± 1.58 to 74.7 ± 1.13 and 163 ± 4.35 to 60.80 ± 1.87, respectively ( < .05). Female patients demonstrated better functional outcomes than male patients. Additionally, patients with intratendinous tears had more favorable results compared to those with subbursal or articular tears. It is important to note that 2 patients did not have ROM data at the 6-month, and 3 patients lacked ROM data at 1-year follow-up due to either retreatment or arthroscopic surgery.
Patients with shoulder stiffness and concomitant RCI can achieve satisfactory functional outcomes following MUA combined with ultrasound-guided platelet-rich plasma injection therapy. Further studies are necessary for a more detailed analysis of subgroups and for long-term follow-up.
麻醉下手法治疗（MUA）联合超声引导下富血小板血浆注射，有望在伴有肩袖损伤（RCI）的肩关节僵硬病例中产生良好的功能预后。关于MUA联合超声引导下富血小板血浆注射治疗伴有RCI的肩关节僵硬的疗效鲜有报道。
从2023年8月开始，30例伴有RCI的肩关节僵硬患者纳入本研究。所有参与者均在本机构接受了MUA，并伴有超声引导下富血小板血浆注射。我们收集并评估了每个受试者的人口统计学数据，以及他们的活动范围（ROM）、视觉模拟量表疼痛评分、Constant-Murley评分、西安大略肩袖指数和磁共振成像图像。这些评估在手术前以及术后2周、6周、3个月、6个月和12个月进行。
所有患者术后ROM均显著改善：前屈从58.70°±6.01°增加到154°±3.59°（P<0.05）；外展从58.20°±6.88°改善到126°±3.04°（P<0.05）；外旋从1-2级进展到3-4级；内旋从1-2级进展到4-5级。51-60岁的患者前屈改善最为显著，而40岁以下的患者外展改善最大。静息时视觉模拟量表平均评分为1.89，表明较术前水平（8.07）有显著改善（P<0.05）。术前和术后Constant-Murley评分和西安大略肩袖指数有显著差异，评分分别从35.
