Frozen shoulder following cardiac surgery; Sri Lankan experience

Abstract

INTRODUCTION: A high incidence of frozen shoulder (FS), of up to 33% is reported in patients undergoing cardiac surgery, which is tenfold higher than in the normal population. Early diagnosis and treatment may prevent progression to chronic, treatment-resistant disease. OBJECTIVES: To study the incidence and associations of acute FS among a cohort of Sri Lankans undergoing coronary artery bypass graft, valve replacement or both cardiac surgeries. METHODS: An observational study was conducted in selected private-sector hospitals in Colombo. Sample size computed was 142 (110 males, mean age 60.28 yrs.) and convenience sampling technique was used where consecutive eligible patients were selected until the required sample size was S149 fulfilled. Patients were recruited to the study while in hospital and reviewed at the two-week and three-month routine follow-up visits. Interviewer administered questionnaire was used to document the demographic data and risk factor associations. Patients presenting with pain and restricted movement of the shoulder joint with positive limitation in lateral rotation, abduction, and medial rotation (LAM test) were considered as having frozen shoulders. RESULTS: Of the142 patients 40.1%(n=57) developed shoulder pain 38.7%(n=55) were LAM test positive. 38.7% (n=55) with both LAM test positivity and shoulder pain were confirmed as having FS. The highest number of patients developing FS were from the 50-60year age group (n=25). Of the associations, dyslipidaemia and ischemic heart disease had significant correlation with the diagnosis of FS (p value<0.05). CONCLUSIONS: More than one third of patients undergoing cardiac surgery developed FS. Ishaemic heat disease and dyslipidaemia showed significant correlation.