{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:50:19Z","timestamp":1791323419686,"version":"4.3.1"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Intervent Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Graphical Abstract<\/jats:bold>\n                  <\/jats:p>","DOI":"10.1007\/s00270-026-04563-8","type":"journal-article","created":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T19:13:08Z","timestamp":1785697988000},"page":"1977-1988","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transarterial Embolization Versus Manipulation Under Anesthesia and Arthroscopic Capsular Release for Refractory Adhesive Capsulitis\u2014A Cost-Effectiveness Analysis"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3164-6133","authenticated-orcid":false,"given":"Kameel","family":"Khabaz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashed","family":"Alananzeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Layth","family":"Alkhani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sammy","family":"Allaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikin","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osman","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,2]]},"reference":[{"issue":"7","key":"4563_CR1","doi-asserted-by":"publisher","first-page":"2176","DOI":"10.1016\/j.arthro.2025.03.027","volume":"41","author":"JP Mullen","year":"2025","unstructured":"Mullen JP, Hauer TM, Lau EN, Lin A. Adhesive capsulitis of the shoulder. Arthroscopy. 2025;41(7):2176\u20138. https:\/\/doi.org\/10.1016\/j.arthro.2025.03.027.","journal-title":"Arthroscopy"},{"issue":"12","key":"4563_CR2","doi-asserted-by":"publisher","first-page":"e544","DOI":"10.5435\/JAAOS-D-17-00606","volume":"27","author":"LH Redler","year":"2019","unstructured":"Redler LH, Dennis ER. Treatment of adhesive capsulitis of the shoulder. J Am Acad Orthop Surg. 2019;27(12):e544. https:\/\/doi.org\/10.5435\/JAAOS-D-17-00606.","journal-title":"J Am Acad Orthop Surg"},{"issue":"4","key":"4563_CR3","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.ocl.2006.09.009","volume":"37","author":"MA Sheridan","year":"2006","unstructured":"Sheridan MA, Hannafin JA. Upper extremity: emphasis on frozen shoulder. Orthop Clin North Am. 2006;37(4):531\u20139. https:\/\/doi.org\/10.1016\/j.ocl.2006.09.009.","journal-title":"Orthop Clin North Am"},{"issue":"12","key":"4563_CR4","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.29581","volume":"3","author":"D Challoumas","year":"2020","unstructured":"Challoumas D, Biddle M, McLean M, Millar NL. Comparison of treatments for frozen shoulder: a systematic review and meta-analysis. JAMA Netw Open. 2020;3(12):e2029581. https:\/\/doi.org\/10.1001\/jamanetworkopen.2020.29581.","journal-title":"JAMA Netw Open"},{"issue":"4","key":"4563_CR5","doi-asserted-by":"publisher","first-page":"193","DOI":"10.3109\/03009747509165255","volume":"4","author":"B Reeves","year":"1975","unstructured":"Reeves B. The natural history of the frozen shoulder syndrome. Scand J Rheumatol. 1975;4(4):193\u20136. https:\/\/doi.org\/10.3109\/03009747509165255.","journal-title":"Scand J Rheumatol"},{"issue":"2","key":"4563_CR6","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.jse.2007.05.009","volume":"17","author":"C Hand","year":"2008","unstructured":"Hand C, Clipsham K, Rees JL, Carr AJ. Long-term outcome of frozen shoulder. J Shoulder Elbow Surg. 2008;17(2):231\u20136. https:\/\/doi.org\/10.1016\/j.jse.2007.05.009.","journal-title":"J Shoulder Elbow Surg"},{"issue":"5","key":"4563_CR7","first-page":"297","volume":"99","author":"J Ramirez","year":"2019","unstructured":"Ramirez J. Adhesive Capsulitis: Diagnosis and Management. AFP. 2019;99(5):297\u2013300.","journal-title":"AFP"},{"issue":"2","key":"4563_CR8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2025.10.027","volume":"37","author":"S Allaw","year":"2026","unstructured":"Allaw S, Khabaz K, Yu Q, Ahmed O. Transarterial embolization for refractory adhesive capsulitis and related tendinopathies: a systematic review and meta-analysis. J Vasc Interv Radiol. 2026;37(2):107896. https:\/\/doi.org\/10.1016\/j.jvir.2025.10.027.","journal-title":"J Vasc Interv Radiol"},{"key":"4563_CR9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919","volume":"355","author":"JA Sterne","year":"2016","unstructured":"Sterne JA, Hern\u00e1n MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. https:\/\/doi.org\/10.1136\/bmj.i4919.","journal-title":"BMJ"},{"key":"4563_CR10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898","volume":"366","author":"JAC Sterne","year":"2019","unstructured":"Sterne JAC, Savovi\u0107 J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. https:\/\/doi.org\/10.1136\/bmj.l4898.","journal-title":"BMJ"},{"key":"4563_CR11","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604","volume-title":"Cochrane handbook for systematic reviews of interventions","author":"JPT Higgins","year":"2019","unstructured":"Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ. Cochrane handbook for systematic reviews of interventions. 2nd ed. John Wiley & Sons; 2019. https:\/\/doi.org\/10.1002\/9781119536604.","edition":"2nd ed"},{"issue":"71","key":"4563_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta24710","volume":"24","author":"S Brealey","year":"2020","unstructured":"Brealey S, Northgraves M, Kottam L, et al. Surgical treatments compared with early structured physiotherapy in secondary care for adults with primary frozen shoulder: the UK FROST three-arm RCT. Health Technol Assess. 2020;24(71):1\u2013162. https:\/\/doi.org\/10.3310\/hta24710.","journal-title":"Health Technol Assess"},{"issue":"1","key":"4563_CR13","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-25","volume":"14","author":"J IntHout","year":"2014","unstructured":"IntHout J, Ioannidis JP, Borm GF. The Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis is straightforward and considerably outperforms the standard DerSimonian-Laird method. BMC Med Res Methodol. 2014;14(1):25. https:\/\/doi.org\/10.1186\/1471-2288-14-25.","journal-title":"BMC Med Res Methodol"},{"issue":"10","key":"4563_CR14","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1001\/jama.2016.12195","volume":"316","author":"GD Sanders","year":"2016","unstructured":"Sanders GD, Neumann PJ, Basu A, et al. Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: second panel on cost-effectiveness in health and medicine. JAMA. 2016;316(10):1093. https:\/\/doi.org\/10.1001\/jama.2016.12195.","journal-title":"JAMA"},{"issue":"10256","key":"4563_CR15","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1016\/S0140-6736(20)31965-6","volume":"396","author":"A Rangan","year":"2020","unstructured":"Rangan A, Brealey SD, Keding A, et al. Management of adults with primary frozen shoulder in secondary care (UK FROST): a multicentre, pragmatic, three-arm, superiority randomised clinical trial. Lancet. 2020;396(10256):977\u201389. https:\/\/doi.org\/10.1016\/S0140-6736(20)31965-6.","journal-title":"Lancet"},{"issue":"5","key":"4563_CR16","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1177\/0272989X13485155","volume":"33","author":"S Dias","year":"2013","unstructured":"Dias S, Welton NJ, Sutton AJ, Ades AE. Evidence synthesis for decision making 5: the baseline natural history model. Med Decis Making. 2013;33(5):657\u201370. https:\/\/doi.org\/10.1177\/0272989X13485155.","journal-title":"Med Decis Making"},{"issue":"9","key":"4563_CR17","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1016\/j.jse.2011.07.032","volume":"21","author":"S Namdari","year":"2012","unstructured":"Namdari S, Yagnik G, Ebaugh DD, et al. Defining functional shoulder range of motion for activities of daily living. J Shoulder Elbow Surg. 2012;21(9):1177\u201383. https:\/\/doi.org\/10.1016\/j.jse.2011.07.032.","journal-title":"J Shoulder Elbow Surg"},{"issue":"2","key":"4563_CR18","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.jvir.2021.10.031","volume":"33","author":"S Bagla","year":"2022","unstructured":"Bagla S, Nagda S, Piechowiak R, Orlando J, Sajan A, Isaacson A. Results from a United States investigational device study of adhesive capsulitis embolization in the treatment of shoulder pain: the adhesive capsulitis embolization study. J Vasc Interv Radiol. 2022;33(2):177\u201382. https:\/\/doi.org\/10.1016\/j.jvir.2021.10.031.","journal-title":"J Vasc Interv Radiol"},{"issue":"1","key":"4563_CR19","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1038\/s41572-022-00386-2","volume":"8","author":"NL Millar","year":"2022","unstructured":"Millar NL, Meakins A, Struyf F, et al. Frozen shoulder Nat Rev Dis Primers. 2022;8(1):59. https:\/\/doi.org\/10.1038\/s41572-022-00386-2.","journal-title":"Frozen shoulder Nat Rev Dis Primers"},{"issue":"1","key":"4563_CR20","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-020-00307-w","volume":"7","author":"T Kraal","year":"2020","unstructured":"Kraal T, L\u00fcbbers J, van den Bekerom MPJ, et al. The puzzling pathophysiology of frozen shoulders \u2013 a scoping review. J Exp Orthop. 2020;7(1):91. https:\/\/doi.org\/10.1186\/s40634-020-00307-w.","journal-title":"J Exp Orthop"},{"issue":"9","key":"4563_CR21","doi-asserted-by":"publisher","first-page":"e199","DOI":"10.1016\/j.jse.2013.12.014","volume":"23","author":"Y Okuno","year":"2014","unstructured":"Okuno Y, Oguro S, Iwamoto W, Miyamoto T, Ikegami H, Matsumura N. Short-term results of transcatheter arterial embolization for abnormal neovessels in patients with adhesive capsulitis: a pilot study. J Shoulder Elbow Surg. 2014;23(9):e199\u2013206. https:\/\/doi.org\/10.1016\/j.jse.2013.12.014.","journal-title":"J Shoulder Elbow Surg"},{"issue":"5","key":"4563_CR22","doi-asserted-by":"publisher","first-page":"e227","DOI":"10.1016\/j.jse.2022.10.021","volume":"32","author":"T Shintaku","year":"2023","unstructured":"Shintaku T, Inui S, Ikegami H, et al. Alteration of chronic inflammatory status by transarterial embolization in frozen shoulder evaluated by fluorine-18 fluorodeoxyglucose positron-emission tomography\/computed tomography. J Shoulder Elbow Surg. 2023;32(5):e227\u201334. https:\/\/doi.org\/10.1016\/j.jse.2022.10.021.","journal-title":"J Shoulder Elbow Surg"},{"issue":"4","key":"4563_CR23","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1016\/j.jse.2021.08.032","volume":"31","author":"J van der Stok","year":"2022","unstructured":"van der Stok J, Fitzsimons M, Queally JM, O\u2019Donnell T. Does capsular distension and a short period of countertraction improve outcome following manipulation under anesthesia for the treatment of primary adhesive capsulitis of the glenohumeral joint? J Shoulder Elbow Surg. 2022;31(4):772\u201381. https:\/\/doi.org\/10.1016\/j.jse.2021.08.032.","journal-title":"J Shoulder Elbow Surg"},{"issue":"9","key":"4563_CR24","doi-asserted-by":"publisher","first-page":"1836","DOI":"10.1016\/j.jse.2020.01.085","volume":"29","author":"Y Hagiwara","year":"2020","unstructured":"Hagiwara Y, Kanazawa K, Ando A, et al. Effects of joint capsular release on range of motion in patients with frozen shoulder. J Shoulder Elbow Surg. 2020;29(9):1836\u201342. https:\/\/doi.org\/10.1016\/j.jse.2020.01.085.","journal-title":"J Shoulder Elbow Surg"},{"issue":"5","key":"4563_CR25","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1016\/j.amjmed.2026.01.021","volume":"139","author":"F Achilova","year":"2026","unstructured":"Achilova F, Daher M, Nassar JE, Daniels AH, Abboud JA. Frozen shoulder: diagnosis and treatment of adhesive capsulitis. Am J Med. 2026;139(5):598\u2013605. https:\/\/doi.org\/10.1016\/j.amjmed.2026.01.021.","journal-title":"Am J Med"},{"key":"4563_CR26","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1097\/00003086-198710000-00008","volume":"223","author":"RJ Neviaser","year":"1987","unstructured":"Neviaser RJ, Neviaser TJ. The frozen shoulder. Diagnosis and management. Clin Orthop Relat Res. 1987;223:59\u201364. https:\/\/doi.org\/10.1097\/00003086-198710000-00008.","journal-title":"Clin Orthop Relat Res"},{"issue":"11","key":"4563_CR27","doi-asserted-by":"publisher","first-page":"2346","DOI":"10.1177\/0363546509348048","volume":"38","author":"AS Neviaser","year":"2010","unstructured":"Neviaser AS, Hannafin JA. Adhesive capsulitis: a review of current treatment. Am J Sports Med. 2010;38(11):2346\u201356. https:\/\/doi.org\/10.1177\/0363546509348048.","journal-title":"Am J Sports Med"},{"issue":"9","key":"4563_CR28","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-003452","volume":"3","author":"S Jones","year":"2013","unstructured":"Jones S, Hanchard N, Hamilton S, Rangan A. A qualitative study of patients\u2019 perceptions and priorities when living with primary frozen shoulder. BMJ Open. 2013;3(9):e003452. https:\/\/doi.org\/10.1136\/bmjopen-2013-003452.","journal-title":"BMJ Open"},{"issue":"1","key":"4563_CR29","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-022-05251-7","volume":"23","author":"SA Lyne","year":"2022","unstructured":"Lyne SA, Goldblatt FM, Shanahan EM. Living with a frozen shoulder \u2013 a phenomenological inquiry. BMC Musculoskelet Disord. 2022;23(1):318. https:\/\/doi.org\/10.1186\/s12891-022-05251-7.","journal-title":"BMC Musculoskelet Disord"},{"issue":"9","key":"4563_CR30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2519\/jospt.2025.13432","volume":"55","author":"M Crestani","year":"2025","unstructured":"Crestani M, Cook C, Leuci C, et al. \u201cI Cannot Recognize My Body\u201d: Experiences and Perceptions of Patients Living With Frozen Shoulder: A Qualitative Systematic Review With Meta-synthesis and Meta-summary. J Orthop Sports Phys Ther. 2025;55(9):1\u201316. https:\/\/doi.org\/10.2519\/jospt.2025.13432.","journal-title":"J Orthop Sports Phys Ther"},{"issue":"1","key":"4563_CR31","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-024-07803-5","volume":"25","author":"F Brindisino","year":"2024","unstructured":"Brindisino F, Sciscione S, Andriesse A, Cioeta M, Struyf F, Feller D. Frozen shoulder: subjects\u2019 needs and perspectives and clinicians\u2019 beliefs and management strategies: do they align? A cross-sectional study. BMC Musculoskelet Disord. 2024;25(1):745. https:\/\/doi.org\/10.1186\/s12891-024-07803-5.","journal-title":"BMC Musculoskelet Disord"},{"issue":"9","key":"4563_CR32","doi-asserted-by":"publisher","first-page":"2495","DOI":"10.1007\/s11136-014-0708-6","volume":"23","author":"S Rodgers","year":"2014","unstructured":"Rodgers S, Brealey S, Jefferson L, et al. Exploring the outcomes in studies of primary frozen shoulder: is there a need for a core outcome set? Qual Life Res. 2014;23(9):2495\u2013504. https:\/\/doi.org\/10.1007\/s11136-014-0708-6.","journal-title":"Qual Life Res"},{"issue":"6","key":"4563_CR33","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.1177\/0363546520956293","volume":"49","author":"J Zhang","year":"2021","unstructured":"Zhang J, Zhong S, Tan T, et al. Comparative efficacy and patient-specific moderating factors of nonsurgical treatment strategies for frozen shoulder: an updated systematic review and network meta-analysis. Am J Sports Med. 2021;49(6):1669\u201379. https:\/\/doi.org\/10.1177\/0363546520956293.","journal-title":"Am J Sports Med"},{"issue":"11","key":"4563_CR34","doi-asserted-by":"publisher","first-page":"2593","DOI":"10.1007\/s00264-022-05558-z","volume":"46","author":"SR Sundararajan","year":"2022","unstructured":"Sundararajan SR, Dsouza T, Rajagopalakrishnan R, P BT, Arumugam P, Rajasekaran S. Arthroscopic capsular release versus manipulation under anaesthesia for treating frozen shoulder \u2014 a prospective randomised study. International Orthopaedics (SICOT). 2022;46(11):2593\u2013601.","journal-title":"International Orthopaedics (SICOT)."}],"container-title":["CardioVascular and Interventional Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00270-026-04563-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00270-026-04563-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00270-026-04563-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:00:21Z","timestamp":1791320421000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00270-026-04563-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,2]]},"references-count":34,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["4563"],"URL":"https:\/\/doi.org\/10.1007\/s00270-026-04563-8","relation":{},"ISSN":["1432-086X"],"issn-type":[{"value":"1432-086X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,2]]},"assertion":[{"value":"1 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"M. P. reports leadership and Fiduciary role for Boston Scientific and Argon. O.A. is a consultant for Argon Medical Devices, Asahi Intecc, Balt USA, Bard Access Systems, Boston Scientific, Canon, Okami Medical, Penumbra, and Trisalus; is a chief medical officer for Flow Medical; and reports research grants from Canon.","order":1,"name":"Ethics","label":"Conflicts of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"For this type of study formal consent is not required.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"For this type of study informed consent is not required.","order":3,"name":"Ethics","label":"Informed Consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"For this type of study consent for publication is not required.","order":4,"name":"Ethics","label":"Consent for Publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}