Shoulder hydrodilatation for primary, post-traumatic and post-operative adhesive capsulitis

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Radiology
• Pain Management

Background:

• Adhesive capsulitis (frozen shoulder) causes significant pain and limited glenohumeral joint mobility.
• It can be primary (idiopathic) or secondary to trauma, surgery, or other shoulder-restricting conditions.
• Optimal management for adhesive capsulitis remains uncertain, with various treatments available.

Purpose of the Study:

• To evaluate the clinical outcomes of glenohumeral hydrodilatation.
• To assess the effectiveness of this procedure across three distinct patient cohorts based on adhesive capsulitis etiology.

Main Methods:

• Retrospective study of 250 patients undergoing hydrodilatation for adhesive capsulitis (2013-2015).
• Procedure performed by a musculoskeletal radiologist under image guidance, injecting a mix of steroids, local anesthetics, and saline (approx. 35mL).
• Patients categorized into idiopathic, post-traumatic, and post-surgical groups; outcomes measured by range of motion and pain levels.

Main Results:

• Significant improvements in abduction (59° to 110°), flexion (50° to 120°), and external rotation (20° to 50°) were observed across all groups.
• Most patients reported a reduction in pain from moderate/severe to mild/none.
• 34 patients (13.6%) required further intervention, including repeat hydrodilatation or arthroscopic capsular release; the diabetic subgroup showed a higher need for these procedures.

Conclusions:

• Glenohumeral hydrodilatation is an effective treatment for adhesive capsulitis, improving range of motion and pain.
• While generally successful, a subset of patients, particularly those with diabetes, may necessitate further interventions.
• No significant difference in outcomes was noted between post-traumatic and post-surgical adhesive capsulitis groups.