311 - Adhesive Capsule Embolization Lowers Recurrence of Shoulder Pain in Frozen Shoulder: A Multi-Institutional Real-World Cohort Analysis

Purpose: To evaluate the real-world role of adhesive capsule embolization (ACE) in patients with adhesive capsulitis (“frozen shoulder) by comparing recurrence rates against matched controls using a large, multi-institutional dataset.

Materials and Methods: We performed a retrospective cohort study utilizing the TriNetX analytics network. We identified patients with adhesive capsulitis undergoing adhesive capsule embolization (ACE) compared to those with no history of ACE. Exclusion criteria included fracture, dislocation, neoplasm, arthritis, or infection to limit specifically to ACE. To ameliorate confounding bias, propensity score matching (PSM 1:1) adjusted for age, sex, BMI, hypertension, diabetes, dyslipidemia, thyroid disease, obesity, and opioid use. Clinical success was determined by recurrence of shoulder pain or lesion codes (ICD-10: M75) related to shoulder pathology (adhesive capsulitis, bursitis, tendonitis, etc.).

Results: ACE patients, matched to 1,074 patients, experienced significantly lower recurrence risk than controls at all timepoints. Event rates in the ACE cohort ranged between 2.2% at 3 months and 3.5% at 18 months, compared with 33.7% to 42.2% in controls, respectively. Relative risk hazard ratios for ACE versus control ranged from 0.054 to 0.064 (all P< 0.001). Recurrence rates in the ACE group plateaued after 12 months, whereas controls showed progressive recurrence throughout follow-up.

Conclusion: ACE was associated with an approximately 90–95% lower risk of recurrence compared with matched controls, with effects persisting through 18 months. These findings support the need for prospective randomized trials to establish the role of ACE in clinical practice.

During the preparation of this work, the author(s) used ChatGPT (GPT-5, OpenAI, 2025) in order to check grammar and spelling. After using this tool, the author(s) reviewed and edited the work and take(s) full responsibility for the content of the abstract.