Experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST): a nested qualitative study.

Objectives: To explore the experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST), a multicentre randomised controlled trial that compared manipulation under anaesthesia (MUA), arthroscopic capsular release (ACR) with a 12-week early structured physiotherapy programme (ESP) in people with unilateral frozen shoulder referred to secondary care.

Design: Nested qualitative study with semistructured interviews. We used constant comparison method to develop our themes.

Surgical treatments compared with early structured physiotherapy in secondary care for adults with primary frozen shoulder: the UK FROST three-arm RCT.

Background: Frozen shoulder causes pain and stiffness. It affects around 10% of people in their fifties and is slightly more common in women. Costly and invasive surgical interventions are used, without high-quality evidence that these are effective.

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

Background: Manipulation under anaesthesia and arthroscopic capsular release are costly and invasive treatments for frozen shoulder, but their effectiveness remains uncertain. We compared these two surgical interventions with early structured physiotherapy plus steroid injection.

Methods: In this multicentre, pragmatic, three-arm, superiority randomised trial, patients referred to secondary care for treatment of primary frozen shoulder were recruited from 35 hospital sites in the UK.

United Kingdom Frozen Shoulder Trial (UK FROST), multi-centre, randomised, 12 month, parallel group, superiority study to compare the clinical and cost-effectiveness of Early Structured Physiotherapy versus manipulation under anaesthesia versus arthroscopic capsular release for patients referred to secondary care with a primary frozen shoulder: study protocol for a randomised controlled trial.

Background: Frozen shoulder (also known as adhesive capsulitis) occurs when the capsule, or the soft tissue envelope around the ball and socket shoulder joint, becomes scarred and contracted, making the shoulder tight, painful and stiff. It affects around 1 in 12 men and 1 in 10 women of working age. Although this condition can settle with time (typically taking 1 to 3 years), for some people it causes severe symptoms and needs referral to hospital.

The ProFHER (PROximal Fracture of the Humerus: Evaluation by Randomisation) trial - a pragmatic multicentre randomised controlled trial evaluating the clinical effectiveness and cost-effectiveness of surgical compared with non-surgical treatment for proximal fracture of the humerus in adults.

Background: Proximal humeral fractures account for 5-6% of all fractures in adults. There is considerable variation in whether or not surgery is used in the management of displaced fractures involving the surgical neck.

Objective: To evaluate the clinical effectiveness and cost-effectiveness of surgical compared with non-surgical treatment of the majority of displaced fractures of the proximal humerus involving the surgical neck in adults.

Surgical vs nonsurgical treatment of adults with displaced fractures of the proximal humerus: the PROFHER randomized clinical trial.

Importance: The need for surgery for the majority of patients with displaced proximal humeral fractures is unclear, but its use is increasing.

Objective: To evaluate the clinical effectiveness of surgical vs nonsurgical treatment for adults with displaced fractures of the proximal humerus involving the surgical neck.

Design, Setting, And Participants: A pragmatic, multicenter, parallel-group, randomized clinical trial, the Proximal Fracture of the Humerus Evaluation by Randomization (PROFHER) trial, recruited 250 patients aged 16 years or older (mean age, 66 years [range, 24-92 years]; 192 [77%] were female; and 249 [99.

Do partial thickness, bursal side cuff tears affect outcome following arthroscopic subacromial decompression? A prospective comparative cohort study.

Background: The present study aimed to compare medium-term clinical outcomes of patients following arthroscopic subacromial decompression (ASAD): those with intact rotator cuff with two groups of increasing size of partial thickness bursal-side tears.

Methods: Patients undergoing shoulder arthroscopy by a single surgeon had pre- and postoperative Constant scores prospectively recorded. Arthroscopic surgery included the assessment of any supraspinatus tears using the Ellman criteria, as well as ASAD and cuff debridement.

Exploring the outcomes in studies of primary frozen shoulder: is there a need for a core outcome set?

Purpose: In our study we explored the need to define a core outcome set for primary frozen shoulder.

Methods: We investigated the outcomes used by studies included in a systematic review of the management of primary frozen shoulder; surveyed which primary outcome measures health care professionals considered important; and re-examined papers previously obtained for a systematic review of patients' views of interventions for frozen shoulder to investigate their views on outcomes.

Results: Thirty-one studies investigated the outcomes range of movement (28 studies), pain (22), function and disability (22), adverse events (13), quality of life (7) and other outcomes (5).

Conservative management following closed reduction of traumatic anterior dislocation of the shoulder.

Background: Acute anterior dislocation, which is the most common type of shoulder dislocation, usually results from an injury. Subsequently, the shoulder is less stable and is more susceptible to re-dislocation, especially in active young adults. This is an update of a Cochrane review first published in 2006.

A questionnaire survey of UK physiotherapists on the diagnosis and management of contracted (frozen) shoulder.

Objective: To gain insights into the diagnosis and management of contracted (frozen) shoulder (CFS) in a sample of UK physiotherapists, underpinning the development of evidence-based clinical guidelines.

Methods: An anonymous online questionnaire was developed and distributed via iCSP, targeting physiotherapists who treat CFS. For treatments, respondents were invited to consider 'pain-predominant' and 'stiffness-predominant' scenarios, choose from listed treatment options, and specify any unlisted conservative options they might consider.

Protocol for the ProFHER (PROximal Fracture of the Humerus: Evaluation by Randomisation) trial: a pragmatic multi-centre randomised controlled trial of surgical versus non-surgical treatment for proximal fracture of the humerus in adults.

Background: Proximal humeral fractures, which occur mainly in older adults, account for approximately 4 to 5% of all fractures. Approximately 40% of these fractures are displaced fractures involving the surgical neck. Management of this group of fractures is often challenging and the outcome is frequently unsatisfactory.

Acromioclavicular joint reconstruction using the Nottingham Surgilig: a preliminary report.

Eleven patients with a chronic acromio-clavicular joint disruption underwent acromio-clavicular joint stabilisation using the Nottingham Surgilig and were followed up clinically and radiologically for an average of 24 months post operation. The mean post-operative Constant score was 83.1, the Imatani score was 81.

A comparison of the Constant and Oxford shoulder scores in patients with conservatively treated proximal humeral fractures.

The Oxford shoulder scores (OSS) and Constant scores were collected prospectively for 103 patients treated conservatively for proximal humeral fractures. The paired scores were analyzed by assessing the degree of correlation, the agreement between the scores, and their sensitivity to change. Linear regression analysis was also performed.

Does the presence of a full-thickness rotator cuff tear influence outcome after proximal humeral fractures?

Background: Prevalence of rotator cuff tears increases with advancing age. Despite proximal humeral fractures being common in the elderly, the influence of a coexistent rotator cuff tear on outcome has, to our knowledge, not been previously investigated. This study prospectively assessed whether the presence of a rotator cuff tear in association with a proximal humeral fracture influences functional prognosis.

Accuracy and dispersal of subacromial and glenohumeral injections in cadavers.

Objective: "Blind" shoulder injections are often inaccurate and infiltrate untargeted structures. We tested a hypothesis that optimizing certain anatomical and positional factors would improve accuracy and reduce dispersal.

Methods: We evaluated one subacromial and one glenohumeral injection technique on cadavers.