Comparison of intra-articular steroid injection versus hydrodilatation with saline and corticosteroid for the treatment of refractory adhesive capsulitis of the shoulder.

Authors

  • Asim Rasool Sahiwal Teaching Hospital & Sahiwal Medical College, Sahiwal.
  • Kashif Raza Khan Sahiwal Teaching Hospital & Sahiwal Medical College, Sahiwal.
  • Haroon-ur-Rehman Gillani Sahiwal Teaching Hospital Sahiwal Medical College, Sahiwal.
  • Majid Rashid Sahiwal Teaching Hospital Sahiwal Medical College, Sahiwal.
  • Muhammad Umair Sahiwal Teaching Hospital & Sahiwal Medical College, Sahiwal.
  • Humayun Israr Sahiwal Teaching Hospital & Sahiwal Medical College, Sahiwal.

DOI:

https://doi.org/10.29309/TPMJ/2023.30.08.7611

Keywords:

Adhesive Capsulitis, Corticosteroid, Disability, Frozen Shoulder, Intra-articular, Pain

Abstract

Objective: To compare the outcome of intra-articular steroid injection versus hydrodilatation with saline and corticosteroid for the treatment of refractory adhesive capsulitis of the shoulder. Study Design: Randomized Controlled Trial. Setting: Department of Orthopaedic Surgery, Sahiwal Teaching Hospital Sahiwal. Period: February 2021 to January 2022. Material & Methods: A total of 156 patients with refractory adhesive capsulitis were randomized. In Group-A, patients were treated with intra articular steroid injection alone and in Group-B, patients were treated with hydrodilatation using corticosteroid and saline. The patients were followed up at 3rd, 6th and 12th week and their functional outcomes was assessed in terms of pain and range of motion (disability) using “Shoulder Pain and Disability Index (SPADI)” scoring system. Results: In a total of 156 patients, 81 (51.9%) were females. The mean age was 51.4±10.6 years (ranged between 33 to 68 years). History of steroid intake was reported in 30 (19%) patients. The mean pain scores on the basis of SPADI scoring at 3-week (p=0.0001), 6-week (p=0.0001) and 12-week (p<0.0001) were significantly less in Group-B when compared to Group-A. The disability scores on the basis of SPADI scoring at 3-week (p<0.0001), 6-week (p<0.0001) and 12-week (p<0.0001) were significantly less in Group-B when compared to Group-A. In comparison to Group-A, functional outcomes were significantly better among patients of Group-B at 6-week (p<0.0001) and 12-week (p<0.0001) intervals. Conclusion: Hydrodilatation along with corticosteroid injection were better treatment options when compared to intra-articular steroid injection alone for reduction in pain and improvement in range of motion among patients with refractory frozen shoulder.

Author Biographies

Asim Rasool, Sahiwal Teaching Hospital & Sahiwal Medical College, Sahiwal.

FCPS (Orthopedics), Assistant Professor Orthopedics, 

Kashif Raza Khan, Sahiwal Teaching Hospital & Sahiwal Medical College, Sahiwal.

FCPS (Orthopedics), Assistant Professor Orthopedics, 

Haroon-ur-Rehman Gillani, Sahiwal Teaching Hospital Sahiwal Medical College, Sahiwal.

FCPS (Orthopedics), Associate Professor Orthopedics, 

Majid Rashid, Sahiwal Teaching Hospital Sahiwal Medical College, Sahiwal.

FCPS (Orothopedics), Senior Registrar Orthopedics, 

Muhammad Umair, Sahiwal Teaching Hospital & Sahiwal Medical College, Sahiwal.

FCPS (Orthopedics), Senior Registrar Orthopedics, 

Humayun Israr, Sahiwal Teaching Hospital & Sahiwal Medical College, Sahiwal.

MBBS, Post Graduate Resident Orthopedics, 

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Published

2023-08-01