Transarterial Embolization Versus Manipulation Under Anesthesia and Arthroscopic Capsular Release for Refractory Adhesive Capsulitis-A Cost-Effectiveness Analysis.

Authors

Kameel Khabaz, Rashed Alananzeh, Layth Alkhani, Sammy Allaw, Xiao Wu, Qian Yu, Mikin Patel, Osman Ahmed

Published in

Cardiovascular and interventional radiology. Aug 02, 2026. Epub Aug 02, 2026.

Abstract

This study compared the cost-effectiveness of transarterial embolization (TAE), manipulation under anesthesia (MUA), and arthroscopic capsular release (ACR) for refractory primary adhesive capsulitis. A systematic review with single-arm meta-analyses informed a three-state Markov model over a 36-month horizon. Clinical success, defined as mild pain at 3 months, was highest for TAE (73.3%), followed by ACR (61.4%) and MUA (55.5%). At a $100,000 per quality-adjusted life-year (QALY) threshold, TAE was the optimal strategy (incremental cost-effectiveness ratio vs. ACR: $77,807/QALY). When success was defined by range-of-motion recovery, MUA and ACR yielded more QALYs at lower cost. Based on indirect comparisons, these findings suggest TAE may be a cost-effective option for pain-predominant adhesive capsulitis, while MUA and ACR may be preferred when mechanical restriction is the primary target.

PMID:
42543403
Bibliographic data and abstract were imported from PubMed on 03 Aug 2026.

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