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Ultrasound-guided hydrodilatation for adhesive capsulitis of the hip is a safe and effective treatment
Byung-Ho Yoon1, Jae-Chan Shim2, MinKi Lee1
1Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea.
Insights
Ultrasound-guided hydrodilatation effectively treats adhesive capsulitis of the hip (ACH), reducing pain and improving function. While generally safe, some patients experience symptom recurrence, though risk factors remain unclear.
Area of Science:
- Orthopedics
- Radiology
- Pain Management
Background:
- Adhesive capsulitis of the hip (ACH) is often underdiagnosed.
- Understanding ACH clinical features and treatment efficacy is crucial.
Purpose of the Study:
- Investigate clinical features of ACH patients.
- Evaluate ultrasound-guided intra-articular hydrodilatation efficacy.
- Assess patient prognosis following treatment.
Main Methods:
- 84 patients (93 hips) diagnosed with ACH were treated.
- Ultrasound-guided hydrodilatation with lidocaine and triamcinolone was administered twice.
- Outcomes measured by VAS, HOOS, ROM, and DFK.
Main Results:
- Significant reduction in VAS pain scores (7.1 to 0.8).
- Improvement in HOOS scores and hip range of motion (ROM).
- Symptom recurrence in 7 patients, without identifiable risk factors.
Conclusions:
- Timely diagnosis and ultrasound-guided hydrodilatation offer pain relief and functional improvement for ACH.
- The procedure demonstrates a favorable safety profile.
- Further research may clarify recurrence factors.
Purpose:
Adhesive capsulitis of the hip (ACH) is likely that this condition had been previously encountered, but easily unrecognised. We investigated the clinical features of patients with ACH, the efficacy of ultrasound-guided intra-articular hydrodilatation, and the patients' prognosis.
Methods:
We enrolled 84 patients (93 hips) who visited the outpatient clinic from August 2018 to November 2019. ACH was diagnosed by restricted range of motion and sharp pain when turning with the affected leg fixed on the ground. We evaluated patient demographics and associated intra-articular pathologies found on magnetic resonance angiography (MRA) images. Injections were performed twice at two week intervals with a mixture of 0.5% lidocaine (25 mL) and triamcinolone (40 mg; 1 mL) with capsular distension under ultrasound guidance. Patients were assessed before and after treatment using a visual analogue scale (VAS), hip disability and osteoarthritis outcome score (HOOS), hip range of motion (ROM), and distance from floor to knee (DFK) when sitting in the cross-legged position.
Results:
On MRA, 18 patients had abnormal findings (eight labral tears, seven abductor tendinosis, three primary arthrosis). The mean VAS decreased from 7.1 ± 1.1 to 0.8 ± 0.9 after the last injection, and the HOOS improved in all subsets. The mean DFK decreased from 17.9 ± 4.8 to 9.7 ± 2.8 cm, and passive ROM showed improvement, especially in flexion and rotation. In seven patients, symptom recurrence was reported a mean of 4.1 months after the latest injection, but no independent risk factor for recurrence was identified.
Conclusion:
Based on these current observations, patients with ACH may receive relief from hip joint pain and experience improved function with a timely diagnosis and effective treatment.
