The Adhesive Capsulitis Corticosteroid and Dilation (ACCorD) randomized controlled trial.

Area of Science:

• Orthopedics
• Musculoskeletal Health
• Clinical Trials

Background:

• Frozen shoulder management in the UK often involves primary care interventions like corticosteroid injections (CSI).
• Current practice shows variation in injection types, including CSI alone versus CSI combined with hydrodilation (HD).
• Musculoskeletal hubs offer infrastructure for early, effective frozen shoulder management, potentially reducing healthcare costs.

Purpose of the Study:

• To determine the feasibility of a definitive multicentre randomized controlled trial (RCT) comparing CSI with HD versus CSI alone for frozen shoulder.
• To evaluate patient and clinician willingness for randomization, recruitment and retention rates, and data collection feasibility.
• To inform future definitive RCT design and potential NICE guideline updates for frozen shoulder treatment.

Main Methods:

• A multicentre feasibility randomized controlled trial (RCT) comparing combined CSI and HD with CSI alone.
• Patients aged 18+ with a clinical diagnosis of frozen shoulder will be randomized and blinded.
• Feasibility outcomes include randomization rates and the use of routinely collected data for outcome evaluation.

Main Results:

• The study will assess recruitment and retention rates, withdrawal, crossover, and attrition.
• Feasibility of collecting outcome data from routine primary and secondary care will be evaluated.
• Patient and public involvement has shaped the trial design and dissemination strategies.

Conclusions:

• This feasibility study is crucial for planning a definitive RCT on CSI with HD for frozen shoulder.
• Successful feasibility will lead to seeking funding for a definitive RCT to inform clinical practice.
• Findings will contribute to evidence-based guidelines for frozen shoulder management, potentially impacting NICE recommendations.