Analysis of hydrodilatation as part of a combined service for stiff shoulder

Abstract

Background

Adhesive capsulitis is a common cause of stiff shoulder and may result in pain and restriction of movement. The study aimed to investigate the role of hydrodilatation of the glenohumeral joint in the management of adhesive capsulitis.

Methods

Patients referred from the shoulder clinic underwent hydrodilatation under ultrasound guidance. Of 209 referred for hydrodilatation, 163 underwent the procedure and attended follow-up physiotherapy. Outcome measures were available for 118 patients (58 men and 60 women). Mean age of the study group was 52.6 years.

Results

There was a statistically significant improvement in both Oxford Shoulder Score (OSS) and Disability Arm Shoulder Hand Scores (Quick DASH) in the first 4 weeks after the procedure, which was maintained but not improved to the end of the study period. Patients presenting with pain, those who had a history of steroid injections and older patients all had worse functional scores at presentation. Diabetes (both Type I and II), previous physiotherapy, length of history and whether pain or stiffness, or both, were the predominant symptom did not have any statistical significance at presentation. These factors were not predictors of any statistically significant improvement in functional scores.

Conclusions

Hydrodilatation results in a significant improvement of symptoms in patients with adhesive capsulitis.

Keywords

adhesive capsulitis arthrodistension frozen shoulder hydrodilatation hydrodistension

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References

Anton

. Frozen shoulder. Can Fam Phys 1993; 39: 1773–1777.

Lundberg

. The frozen shoulder. Acta Orthop Scand 1969; 119(Suppl): 5–59.

Bunker

. Time for a new name for frozen shoulder – contracture of the shoulder. Shoulder Elbow 2009; 1: 4–9.

Dias

Cutts

Massoud

. Frozen shoulder. BMJ 2005; 331: 1453–1456.

Rizk

Pinals

. Frozen shoulder. Semin Arthritis Rheum 1982; 11: 440–452.

Bridgman

. Periarthritis of the shoulder and diabetes mellitus. Ann Rheum Dis 1972; 31: 69–71.

Reeves

. The natural history of the frozen shoulder syndrome. Scand J Rheumatol 1975; 4: 193–196.

Hand CA. Long term follow up of outcome of patients with frozen shoulder. Annual Scientific Meeting BESS 2005, Cambridge, 2005.50.

Hand

Clipsman

Rees

. The long term outcome of frozen shoulder. J Shoulder Elbow Surg 2008; 17: 231–236.

10.

Andren

Lundberg

. Treatment of rigid shoulders by joint distension during arthrography. Acta Orthop Scand 1965; 36: 45–53.

11.

Zwar

Read

Noakes

. Sonographically guided glenohumeral joint injection. AJR Am J Roentgenol 2004; 183: 48–50.

12.

Buchbinder

Green

Youd

. Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev 2003; 1: CD004016–CD004016.

13.

Quraishi

Johnston

Bayer

. Thawing the frozen shoulder. A randomised trial comparing manipulation under anaesthesia with hydrodilatation. J Bone Joint Surg Br 2007; 89: 1197–1200.

14.

Smith

Hamer

Bunker

. Arthroscopic capsular release for idiopathic frozen shoulder with intra-articular injection and a controlled manipulation. J Shoulder Elbow Surg 2000; 9: 23–26.

15.

Yoong

Duffy

McKean

. Targeted ultrasound-guided hydrodilatation via the rotator cuff interval for adhesive capsulitis. Skeletal Radiol 2015; 44: 703–708.

16.

Granville-Chapman

. Long-term results of hydrodistension for frozen shoulder. Shoulder Elbow 2015; 7: 309–332.

17.

Ekelund

Rydell

. Combination treatment for adhesive capsulitis of the shoulder. Clin Orthop Relat Res 1992; 282: 105–109.

18.

Fareed

Gallivan

Jr . Office management of frozen shoulder syndrome: treatment with hydraulic distension under local anesthesia. Clin Orthop Relat Res 1989; 242: 177–183.

19.

Gavant

Rizk

Gold

. Distension arthrography in the treatment of adhesive capsulitis of the shoulder. J Vasc Intervent Radiol 1994; 5: 305–308.

20.

Loyd

. Adhesive capsulitis of the shoulder: arthrographic diagnosis and treatment. South Med J 1983; 76: 879–883.

21.

Older

MWJ

Distension arthrography of the shoulder joint. In: Bayley

Kessel

(eds). Shoulder surgery, Berlin: Springer, 1982, pp. 123–127.

22.

Mulcahy

Baxter

Oni

OOA

. The value of shoulder distension arthrography with intraarticular injection of steroid and local anaesthetic: a follow-up study. Br J Rheumatol 1994; 67: 263–266.

23.

Royen

Pavlov

. Treatment of frozen shoulder by distension and manipulation under local anaesthesia. Int Orthop 1996; 20: 207–210.

24.

Hsu

SYC

Chan

. Arthroscopic distension in the management of frozen shoulder. Int Orthop 1991; 15: 79–83.

25.

Urwin

Symmons

Allison

. Estimating the burden of musculoskeletal disorders in the community:the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Am Rheum Dis 1998; 557: 649–655.

26.

van der Windt

Thomas

Pope

. Occupational risk factors for shoulder pain: a systematic review. Occup Env Med 2000; 57: 433–442.

27.

van der Windt

Koes

de Jong

. Shoulder disorders in general practice: incidence, patient characteristics and management. Ann Rheum Dis 1995; 54: 959–964.

28.

Linsell

Dawson

Zondervan

. Prevalence and incidence of adults consulting for shoulder conditions in UK primary care; patterns of diagnosis and referral. Rheumatology 2006; 45: 215–221.

29.

Clement

. Frozen shoulder: long-term outcome following arthrographic distension. Acta Orthop Belg 2013; 79: 368–374.

30.

Maund

Craig

Suekarran

. Management of frozen shoulder: a systematic review and cost-effectiveness analysis. Health Technol Assess 2012; 16: 1–264.