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Neither early structured physiotherapy, manipulation under anaesthesia nor arthroscopic capsular release was found to be clearly superior on patient-reported shoulder pain and functioning at 12 months.

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Stephen Brealey 1, Matthew Northgraves 1, Lucksy Kottam 2, Ada Keding 1, Belen Corbacho 1, Lorna Goodchild 3, Cynthia Srikesavan 4, Saleema Rex 1, Charalambos P Charalambous 5,6, Nigel Hanchard 7, Alison Armstrong 8, Andrew Brooksbank 9, Andrew Carr 4, Cushla Cooper 4, Joseph Dias 8, Iona Donnelly 9, Catherine Hewitt 1, Sarah E Lamb 4, Catriona McDaid 1, Gerry Richardson 10, Sara Rodgers 1, Emma Sharp 9, Sally Spencer 11, David Torgerson 1, Francine Toye 12, Amar Rangan 1,2,4,*

1 York Trials Unit, Department of Health Sciences, University of York, York, UK
2 The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
3 The Physiotherapy Practice, South Shields, UK
4 Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
5 Department of Orthopaedics, Blackpool Victoria Hospital, Blackpool, UK
6 School of Medicine, University of Central Lancashire, Preston, UK
7 School of Health & Life Sciences, Teesside University, Middlesbrough, UK
8 University Hospitals of Leicester NHS Trust, Leicester, UK
9 Glasgow Royal Infirmary, Glasgow, UK
10 Centre for Health Economics, University of York, York, UK
11 Postgraduate Medical Institute, Edge Hill University, Ormskirk, UK
12 Physiotherapy Research Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
* Corresponding author Email: amar.rangan@york.ac.uk

Declared competing interests of authors: Lucksy Kottam reports grants from the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme for other work during the conduct of this study. South Tees Hospitals NHS Foundation Trust receives an educational grant to the Department of Trauma and Orthopaedic Surgery from DePuy Synthes (Warsaw, IN, USA; part of the Johnson & Johnson Medical Devices group). It also receives payment from DePuy Synthes for Lucksy Kottam as a study co-ordinator for the GLOBAL ICON Stemless Shoulder System Post Market Clinical Follow Up Study: CT 1401. These payments are outside and unrelated to the submitted work. Catherine Hewitt is a member of the NIHR HTA Commissioning Board. Catriona McDaid receives funding from the British Orthopaedic Association (2014 to present). She is a member of the NIHR HTA and Efficacy and Mechanism Evaluation Editorial Board (2017 to present). Sarah E Lamb reports membership of the following boards: HTA Additional Capacity Funding Board 2012–15, HTA Clinical Trials Board 2010–15, HTA End of Life Care and Add on Studies Board 2015, HTA Funding Boards Policy Group (formerly Clinical Studies Group) 2010–15, HTA Maternal, Neonatal and Child Health Methods Group 2013–15, HTA Post-board funding teleconference 2010–15, HTA Primary Care Themed Call Board 2013–14, HTA Prioritisation Group 2010–15 and the NIHR Clinical Trials Unit Standing Advisory Committee 2012–16. Amar Rangan reports other grants from the NIHR HTA programme, Orthopaedic Research UK (London, UK) and Horizon 2020 during the conduct of the study. South Tees Hospitals NHS Foundation Trust receives an educational grant to the department from DePuy Synthes. The institution also receives payment from DePuy Synthes for Amar Rangan as the co-ordinating investigator for the GLOBAL ICON Stemless Shoulder System Post Market Clinical Follow Up Study: CT 1401. These are outside and unrelated to the submitted work. Joseph Dias reports grants from NIHR during the conduct of the study, outside the submitted work.

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