Ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy for treatment of frozen shoulder

Abstract

BACKGROUND:

Frozen shoulder (FS), also known as shoulder adhesive capsulitis, is a musculoskeletal disorder associated with pain and functional disability. There is a lack of evidence on the optimal treatment strategy for FS.

OBJECTIVE:

The present study aimed to evaluate the effectiveness and safety of ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy for treatment of FS.

METHODS:

In this prospective randomized, double-blind, controlled study, 63 FS patients were recruited, and equally allocated to treatment group and control group. The treatment group was treated with ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy, while the control group was only treated with ultrasound-guided hydrodilatation of glenohumeral joint. The pain and mobility of shoulder, overall efficacy and adverse reactions were evaluated 3 months after treatment.

RESULTS:

At baseline, no significant difference in all characteristic value was found between the treatment group ( $n=$ 33) and control group ( $n=$ 30). Three months after operation, the joint’s Active Range of Motion (AROM) and Constant-Murley Scale (CMS) scores in the experimental group were higher than those in the control group, and the coracohumeral ligament (CHL) thickness and the rate of hypoechoic thickening in rotator cuff space in the experimental group were lower than those in the control group (all $P<$ 0.05). The amount of injection volume at the third hydrodilatation was significantly higher in the experimental group than that in the control group (15.8 $\pm$ 4.7 vs 12.2 $\pm$ 5.2, $P=$ 0.03). After 2 times of treatment, the volume increment of glenohumeral joint $\mathrm{\Delta }$ 2 in the experimental group was greater than that in the control group (3.5 $\pm$ 1.8 vs 1.2 $\pm$ 1.6, $P<$ 0.001). There were significant differences in the effective rate between the two groups (93.94% vs. 76.67%, $P=$ 0.04).

CONCLUSION:

The ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy may benefit FS patients.