2024 AAOS Annual Meeting: Watchful waiting achieves higher value than physical therapy for the treatment of idiopathic frozen shoulder: a prospective randomized controlled trial

61 patients with idiopathic frozen shoulder were randomized to receive either watchful waiting (WW; n=31) or physical therapy (PT; n=30). The primary outcome of interest was the American Shoulder and Elbow Surgeons score (ASES) questionnaire. Secondary outcomes of interest included pain scores on a Visual Analog Scale (VAS), the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, direct patient healthcare costs, and patient value (defined as the 12-month ASES score divided by healthcare costs). Outcomes were assessed at baseline, 6 weeks, and 3, 6, and 12 months. Both cohorts improved at each time point for all primary outcomes, but no significant differences in patient-reported outcomes (PROMs) between treatment modalities were found at any time point. WW patients incurred significantly lower direct costs than PT patients, with a normalized mean difference was of 1,635.67. Patients in the WW group also achieved greater patient value, with a normalized mean difference of -146.97. Both of these differences were statistically significant.