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Intra-articular steroid for adhesive capsulitis: does hydrodilatation give any additional benefit? A randomized control trial.

Abstract：

OBJECTIVES:To assess the benefit offered by capsular hydrodilatation in addition to intra-articular steroid injections in cases of adhesive capsulitis, assess outcomes in diabetic patients with capsular hydrodilatation as compared to non-diabetics and correlate duration of symptoms with outcome based on the type of intervention given. MATERIALS AND METHODS:This prospective double-blinded randomized control trial included patients presenting with clinical features of adhesive capsulitis with no evidence of rotator cuff pathology and randomized them into two groups-intra-articular steroid with hydrodilatation (distension group) and only intra-articular steroid (non-distension group) with intervention being performed as per the group allotted. Primary outcome measure was Shoulder Pain and Disability Index (SPADI) scores which were taken pre-intervention, at 1.5, 3 and 6 months post-intervention, which were assessed by generalized linear model statistics and Pearson correlation. RESULTS:Although there was statistically significant drop in SPADI in both groups over time [F(1.9, 137.6) = 112.2; p < 0.001], mean difference in SPADI between the 2 groups was not statistically significant (1.53; CI:-3.7 to 6.8; p = 0.56). There was no significant difference between both groups among diabetics [F(1,38) = 0.04; p = 0.95] and no significant difference between diabetic and non-diabetic patients who received hydrodilatation [F(1.8, 60) = 2.26; p = 0.12]. There was no significant correlation between the reduction in SPADI scores and duration of symptoms in any subset of the study population. CONCLUSION:Shoulder joint hydrodilatation offered no additional benefit compared to intra-articular steroid injections for shoulder adhesive capsulitis. Outcome for diabetics and non-diabetics were similar and there was no correlation between duration of symptoms and outcome.

journal_name

Skeletal Radiol

journal_title

Skeletal radiology

authors

Paruthikunnan SM,Shastry PN,Kadavigere R,Pandey V,Karegowda LH

doi

10.1007/s00256-019-03316-8

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

795-803

issue

eissn

0364-2348

issn

1432-2161

pii

10.1007/s00256-019-03316-8

journal_volume

pub_type

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Intra-articular steroid for adhesive capsulitis: does hydrodilatation give any additional benefit? A randomized control trial.