Hydrodissection and hydrodilatation for joint pain: a scoping review

To evaluate the current evidence regarding the effectiveness and safety of ultrasound-guided hydrodissection (US-HD) in the management of joint-related pain.

A systematic search of PubMed, Embase, Cochrane Library, and Google Scholar was conducted for studies published in the past 15 years. Eligible studies included randomised controlled trials (RCTs), cohort studies, and case series investigating hydrodissection for joint pain (e.g., shoulder, hip, knee, sacroiliac joint). Outcomes included pain reduction, functional improvement, and complication rates. Data extraction and qualitative synthesis were performed due to heterogeneity in study design and outcome measures.

A total of 138 studies were identified, of which 21 met inclusion criteria. Evidence suggests that US-HD may provide significant pain relief and functional improvement in conditions such as adhesive capsulitis, greater trochanteric pain syndrome, and knee osteoarthritis. Studies consistently reported low complication rates. However, heterogeneity in technique, injectate composition, and outcome measures was noted.

Ultrasound-guided hydrodissection appears to be a safe and promising intervention for joint-related pain. While early evidence is encouraging, larger high-quality trials are required to establish standardised protocols and confirm long-term efficacy.