Prevalence of acute frozen shoulder with functional limitation following cardiac surgery: A descriptive study from Sri Lanka

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, treatmentresistant disease. However, data on the prevalence of acute FS following cardiac surgery in Sri Lanka is not known. The aim of this study was to identify the prevalence and associations of acute FS following coronary artery bypass graft with or without valve replacement in two cardiac surgical units in Sri Lanka. METHODS: We studied consecutive patients who underwent cardiac surgery from April 2022 to November 2022. Patients were recruited to the study before discharge from the hospital and were reviewed at 2 and 12 weeks following surgery. Acute FS was diagnosed in the presence of pain and limitation in lateral rotation, abduction, and medial rotation. Data on demographics and risk factors were collected using an interviewer-administered questionnaire. RESULTS: We studied 142 patients, 110 (77%) males, mean age of 60.3 SD years (range 28-78 years), 142 had coronary artery bypass grafting (CABG) and 3 of them additionally had valve replacement. Of them, 55 (38.7%) developed FS at 12 weeks post-surgery. Prevalence of FS was highest among the 50-60-year age group, 25 (45%). Development of post-surgical acute FS was more in patients with ischaemic heart disease (OR 5.5, p <0.01), hyperlipidaemia (OR 15.1, p<0.01), and who did not have regular post-op physiotherapy (6.1 p<0.01). CONCLUSION: More than one-third of patients undergoing cardiac surgery developed acute FS at 12 weeks. Patients with ischaemic heart disease, and hyperlipidaemia, and who did not engage in regular post-op physiotherapy were at high risk of developing acute FS.