In this study, a series of successful manipulations under anesthesia had limited effect in the follow-up period, probably because of the recurrence of adhesions in the first weeks after manipulation. We did not note major complications with manipulation, but small injuries of the joint were possible, as has been verified on arthroscopy after manipulation.14
Randomization led to good comparability between the 2 treatment groups in our study. Patients in the 2 groups had used other treatments equally, and as there was no difference in outcome between the 2 groups, no cost-effectiveness analysis was indicated. A blinded assessor gathered questionnaire data at baseline and during the entire follow-up period and also measured glenohumeral mobility; this procedure increased the reliability of the findings.