The Efficacy of Ultrasound-Guided Capsule-Preserving Hydrodilatation with Corticosteroid Versus Conventional Corticosteroid Injection in Shoulder Adhesive Capsulitis: A Randomized, Double-Blinded, Controlled Trial
Keywords:
adhesive capsulitis, capsule-preserving hydrodilatation, corticosteroid, ultrasound-guided, range of motionAbstract
Objectives: To compare the outcomes of treating subacute adhesive capsulitis (AC) using capsule-preserving hydrodilatation with corticosteroid (CPHC) versus intra-articular corticosteroid injection (IACI)
Study design: A randomized, double-blinded, controlled trial
Setting: Chaophrayayommarat Hospital, Suphanburi, Thailand
Subjects: Fifty-two participants with AC and shoulder pain who had a numeric rating scale (NRS) of at least four after having received physical therapy for at least one month.
Methods: Eligible patients were randomly allocated either to the study group treated with CPHC or to the control group treated with IACI. The CPHC group (n=26) received a mixture of 4 mL of triamcinolone (10 mg/mL), 6 mL of 1% lidocaine, and 10 mL of normal saline, whereas the IACI group (n=26) received a mixture of 4 mL of triamcinolone (10 mg/mL) and 1 mL of 1% lidocaine. Following that, all participants underwent physical therapy at the hospital and a participated in a home exercise program. The primary outcome was shoulder passive range of motion (PROM). Secondary outcomes were subjective numeric rating scale (NRS), the Shoulder Pain and Disability Index (SPADI), and the Oxford Shoulder Score (OSS). Assessments were conducted at baseline and at 1- and 6-weeks post-treatment.
Results: At one week post-treatment, all outcomes were significantly different from baseline in both groups. The SPADI-disability and SPADI-total scores were significantly different between groups. At six weeks, all outcomes showed a strongly significant improvement in both groups and significant differences between groups except the internal rotation.
Conclusions: Capsule-preserving hydrodilatation with corticosteroid combined with physical therapy and a home exercise program demonstrated superior efficacy to intra-articular corticosteroid injection combined with the same physical therapy and a home exercise program for treating subacute adhesive capsulitis, resulting in improved ROM, reduced pain, and restored shoulder function
References
Wu WT, Chang KV, Han DS, Chang CH, Yang FS, Lin CP. Effectiveness of glenohumeral joint dilatation for treatment of frozen shoulder: a systematic review and meta-analysis of randomized controlled trials. Sci Rep [Internet]. 2017 [cited 2020 Jan 23];7:10507. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585252/ doi: 10.1038/s41598-017-10895-w
Song A , Higgins LD, Newman J, Jain NB. Glenohumeral corticosteroid injections in adhesive capsulitis: a systematic search and review. PM R [Internet]. 2014 [cited 2020 Jan 22];6(12): 1143-56. Available from: https://pubmed.ncbi.nlm.nih.gov/24998406/ doi: 10.1016/j.pmrj.2014.06.015
Sharma SP, Baerheim A, Moe-Nilssen R, Kvale A. Adhesive capsulitis of the shoulder, treatment with corticosteroid, corticosteroid with distension or treatment-as-usual; a randomised controlled trial in primary care. BMC Musculoskelet Disord [Internet]. 2016 [cited 2020 Jan 25];17:232. Available from: https://www.researchgate.net/publication/303537429/ doi: 10.1186 /s12891-016-1081-0
Lee DH, Yoon SH, Lee MY, Kwack KS, Rah UW. Capsule-preserving hydrodilatation with corticosteroid versus corticosteroid injection alone in refractory adhesive capsulitis of shoulder: a randomized controlled trial. Arch Phys Med Rehabil [Internet]. 2017 [cited 2020 Jan 22];98:815-21. Available from: https://www.archives-pmr.org/article/S0003-9993(16)31232-1 doi: 10.1016/j.apmr.2016.10.012
Park KD, Nam HS, Kim TK, Kang SH, Lim MH, Park Y. Comparison of sono-guided capsular distension with fluoroscopically capsular distension in adhesive capsulitis of shoulder. Ann Rehabil Med [Internet]. 2012 [cited 2020 Aug 24];36:88–97. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3309313/ doi: 10.5535/arm.2012.36.1.88
Bae JH, Park YS, Chang HJ, Kim JM, Park KY, Jin SH, et al. Randomized controlled trial for efficacy of capsular distension for adhesive capsulitis: fluoroscopy-guided anterior versus ultrasonography guided posterolateral approach. Ann Rehabil Med [Internet]. 2014 [cited 2020 Aug 24];38:360-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles /PMC4092177/ doi: 10.5535/arm.2014.38.3.360
Sinha R, Patel P, Rose N, Tuckett J, Banerjee AN, Williams J, et al. Analysis of hydrodilatation as part of a combined service for stiff shoulder. Shoulder Elbow [Internet]. 2017 [cited 2020 Jan 22];9(3):169–77. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5444603/ doi: 10.1177/1758573216687273
Maryam M, Zahra K, Adeleh B, Morteza Y. Comparison of corticosteroid injections, physiotherapy, and combination therapy in treatment of frozen shoulder. Pak J Med Sci [Internet]. 2012 [cited 2020 May 22];28(4):648-51. Available from: https://pjms.com.pk/index.php/pjms/article/view/2059
Buchbinder R, Youd JM, Green S, Stein A, Forbes A, Harris A, et al. Efficacy and cost-effectiveness of physiotherapy following glenohumeral joint distension for adhesive capsulitis: a randomized trial. Arthritis Rheum [Internet]. 2007 [cited 2020 May 20];57(6):1027-37. Available from: https://pubmed.ncbi.nlm.nih.gov/17665470/ doi: 10.1002/art.22892
Tveita EK, Tariq R, Sesseng S, Juel NG, Bautz-Holter E. Hydrodilatation, corticosteroids and adhesive capsulitis: a randomized controlled trial. BMC Musculoskelet Disord [Internet]. 2008 [cited 2020 Jan 22];9:53. Available from: https://pubmed.ncbi.nlm.nih.gov/18423042/ doi: 10.1186/1471-2474-9-53
Buchbinder R, Green S, Youd JM, Johnston RV, Cumpston M. Arthrographic distension for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev [Internet]. 2008 [cited 2020 May 20]:Cd007005. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007005/ doi: 10.1002/14651858.CD007005
Lin MT, Hsiao MY, Tu YK, Wang TG. Comparative efficacy of intra-articular steroid injection and distension in patients with frozen shoulder: a systematic review and network meta-analysis. Arch Phys Med Rehabil [Internet]. 2018 [cited 2020 May 22];99(7):1383-94.e6. Available from: https://www.archives-pmr.org/article/S0003-9993(17)31077-8/ doi: 10.1016/j.apmr.2017.08.471
Saltychev M, Laimi K., Virolainen P, Fredericson M. Effectiveness of hydrodilatation in adhesive capsulitis of shoulder: a systematic review and meta-analysis. Scand. J. Surg [Internet]. 2018 [cited 2020 Aug 24] ;107(4):285-93. Available from: https://pubmed.ncbi.nlm.nih.gov/29764307/ doi: 10.1177/1457496918772367
Poonnark W. A retrospective study of ultrasound guided capsular hydrodilatation with a mixture of normal saline, lidocaine, and triamcinolone injection in patient with adhesive capsulitis. ASEAN J Rehabil Med 2019:29(1):30-6.
Park KD, Nam HS, Lee JK, Kim YJ, Park Y. Treatment effects of ultrasound-guided capsular distension with hyaluronic acid in adhesive capsulitis of the shoulder. Arch Phys Med Rehabil [Internet]. 2013 [cited 2020 Apr 22]:94:264-70. Available from: https://pubmed.ncbi.nlm.nih.gov/23063625/ doi: 10.1016/j.apmr.2012.10.002
Bryant M, Gough A, Selfe J, Richards J, Burgess E. The effectiveness of ultrasound guided hydrodistension and physiotherapy in the treatment of frozen shoulder/adhesive capsulitis in primary care: a single centre service evaluation. Shoulder Elbow [Internet]. 2017 [cited 2020 Jan 28];9(4):292–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598823/ doi: 10.1177/1758573217701063
Yoon SH, Lee HY, Lee HJ, Kwack KS. Optimal dose of intra-articular corticosteroids for adhesive capsulitis: a randomized, triple-blind, placebo-controlled trial. Am J Sports Med [Internet]. 2013 [cited 2020 Feb 10];41:1133-9. Available from: https://journals.sagepub.com/ doi:10.1177/0363546513480475
Leung MSF, Cheing GLY. Effects of deep and superficial heating in the management of frozen shoulder. J Rehabil Med [Internet]. 2008 [cited 2020 May 18];40(2):145-50. Available from: https://pubmed.ncbi.nlm.nih.gov /18509580/ doi: 10.2340/16501977-0146
Phongamwong C, Choosakde A. Reliability and validity of the Thai version of the shoulder pain and disability index (Thai SPADI). Health Qual Life Outcomes [Internet]. 2015 [cited 2020 Feb 22]:13:136. Available from: https://pubmed.ncbi.nlm.nih.gov/26337915/ doi: 10.1186/s12955-015-0333-2
Tantisiriwat N, Wongmatikul V, Jaroenarpornwatana A, Janchai S. Validation and reliability of the thai version of the oxford shoulder score. J Med Assoc Thai [Internet]. 2018 [cited 2020 Jan 25]:101 (4):509-15. Available from: https://www.thaiscience.info/Journals/Article/JMAT/10989501.pdf
Roy JS, MacDermid JC, Woodhouse LJ. Measuring shoulder function: a systematic review of four questionnaires. Arthritis Rheum [Internet]. 2009 [cited 2020 May 22];61(5):623-32. Available from: https://pubmed.ncbi.nlm.nih.gov /19405008/ doi: 10.1002/art.24396
Ekeberg OM, Bautz-Holter E, Keller A, Tveita EK, Juel NG, Brox JI. A questionnaire found disease-specific WORC index is not more responsive than SPADI and OSS in rotator cuff disease. J Clin Epidemiol [Internet]. 2010 [cited 2020 Feb 15];63:575-84. Available from: https://doi.org/10.1016/j.jclinepi.2009.07. https://pubmed.ncbi.nlm.nih.gov/19836206/ doi: 10.1016/j.jclinepi.2009.07.012
van Kampen DA, Willems WJ, van Beers LWAH, Castelein RM, Scholtes VAB, Terwee CB. Determination and comparison of the smallest detectable change (SDC) and the minimal important change (MIC) of four-shoulder patient-reported outcome measures (PROMs). J Orthop Surg Res [Internet]. 2013 [cited 2020 Feb 15];8:40. Available from: https://pubmed.ncbi.nlm.nih.gov/24225254/ doi: 10.1186/1749-799X-8-40
Wang JC, Tsai PY, Hsu PC, Huang JR, Wang KA4, Chou CL, et al. Ultrasound-guided hydrodilatation with triamcinolone acetonide for adhesive capsulitis: a randomized controlled trial comparing the posterior glenohumeral recess and the rotator cuff interval approaches. Front Pharmacol [Internet]. 2021 [cited 2022 Jan 16] ;7:12:686139. Available from: https://www.frontiersin.org/journals/ pharmacology/ articles/ 10.3389/ fphar.2021.686139/full doi: 10.3389/fphar.2021.68613
Buchbinder R, Green S, Forbes A, Hall S, Lawler G. Arthrographic joint distension with saline and steroid improves function and reduces pain in patients with painful stiff shoulder: Results of a randomised, double blind, placebo controlled trial. Ann Rheum Dis [Internet]. 2004 [cited 2020 May 18];63(3):302–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1754915/ doi: 10.1136/ard.2002.004655
Reza SS, Bijan F, Asghar HA, Morteza T. Treatment of frozen shoulder: A double-blind study comparing the impact of triamcinolone injection alone or in association with joint distention. Res J Pharm Biol Chem Sci [Internet]. 2013 [cited 2020 May 18];4:226-34. Available from: https://www.researchgate.net/publication/287312188
Catapano M, Mittal N, Adamich J, Kumbhare, Sangha H. Hydrodilatation with corticosteroid for the treatment of adhesive capsulitis: A Systematic Review. PM R [Internet]. 2018 [cited 2023 May 19];10(6):623-35. Available from: https://pubmed.ncbi.nlm.nih.gov/29129609/ doi: 10.1016/j.pmrj.2017.10.013
Gam AN, Schydlowsky P, Rossel I, Remvig L, Jensen EM. Treatment of “frozen shoulder” with distension and glucorticoid compared with glucorticoid alone. A randomised controlled trial. Scand J Rheumatol [Internet].1998 [cited 2023 May 19];27:425-30. Available from: https://pubmed.ncbi.nlm.nih.gov/9855212/ doi: 10.1080/030097498442244
Ibrahim T, Rahbi H, Beiri A, Jeyapalan K, Taylor GJ. Adhesive capsulitis of the shoulder: the rate of manipulation following distension arthrogram. Rheumatol Int [Internet]. 2006 [cited 2021 May 28];27:7-9. Available from: https://pubmed.ncbi.nlm.nih.gov/16871412/ doi: 10.1007/s00296-006-0160-1
Bell S, Coghlan J, Richardson M. Hydrodilatation in the management of shoulder capsulitis. Australas Radiol [Internet]. 2003 [cited 2021 May 28];47:247-51. Available from: https://pubmed.ncbi.nlm.nih.gov/12890243/ doi: 10.1046/j.1440-1673.2003.01171.x
Mengiardi B, Pfirrmann CW, Gerber C, Hodler J, Zanetti M. Frozen shoulder: MR arthrographic findings. Radiology [Internet]. 2004 [cited 2021 May 28];233:486-92. Available from: https://pubmed.ncbi.nlm.nih.gov/15358849/ doi: 10.1148/radiol.2332031219
Lee JH, Kim SB, Lee KW, Lee SJ, Lee JU. Effect of hypertonic saline in intra-articular hydraulic distension for adhesive capsulitis. PM R [Internet]. 2015 [cited 2020 Jan 22];7:721-6. Available from: https://pubmed.ncbi.nlm.nih.gov/25937021/ doi: 10.1016/j.pmrj.2015.04.013
Bill TJ, Clayman MA, Morgan RF, Gampper TJ. Lidocaine metabolism pathophysiology, drug interactions, and surgical implications. Aesthet Surg J [Internet]. 2004 [cited 2024 Feb 28];24;307-11. Available from: https://academic.oup.com/asj/article/24/4/307/210743 doi: 10.1016/j.asj.2004.05.001
Jayaram P, Kennedy DJ, Yeh P, Dragoo J. Chondrotoxic effects of local anesthetics on human knee articular cartilage: A Systematic Review.PM R [Internet]. 2019 [cited 2023 Dec 20];11(4):379-400. Available from: https://pubmed.ncbi.nlm.nih.gov/30676699/ doi: 10.1002/pmrj.12007
Grishko V, Xu M, Wilson G, Pearsall AW. Apoptosis and mitochondrial dysfunction in human chondrocytes following exposure to lidocaine, bupivacaine, and ropivacaine. J Bone Joint Surg Am [Internet]. 2010 [cited 2023 Dec 20];92(3):609-18. Available from: https://pubmed.ncbi.nlm.nih.gov/20194319/ doi: 10.2106/JBJS.H.01847
Song A, Higgins LD, Newman J, Jain NB. Glenohumeral corticosteroid injections in adhesive capsulitis: a systematic search and review. PM & R [Internet]. 2014 [cited 2022 Oct 18];6(12):1143–56. Available from: https://pubmed.ncbi.nlm.nih. gov/24998406/ doi: 10.1016/j.pmrj.2014.06.015
Caldwell JR. Intra-articular corticosteroids. Guide to selection and indications for use. Drugs [Internet]. 1996 [cited 2020 Oct 24];52:507-14. Available from: https://pubmed.ncbi.nlm.nih.gov/8891463/ doi: 10.2165/00003495-199652040-00004
Yoon JP, Chung SW, Kim JE, Kim HS, Lee HJ, Jeong WJ, et al. Intra-articular injection, subacromial injection, and hydrodilatation for primary frozen shoulder: a randomized clinical trial. J Shoulder Elbow Surg [Internet]. 2016 [cited 2022 Oct 18];25:376-83. Available from: https://pubmed.ncbi.nlm.nih.gov/26927433 doi: 10.1016/j.jse.2015.11.00
Koide M, Hamada J, Hagiwara Y, Kanazawa K, Suzuki K. A thickened coracohumeral ligament and superomedial capsule limit internal rotation of the shoulder joint: Report of Three Cases. Case Rep Orthop [Internet]. 2016 [cited 2024 Feb 19];2016:9384974. Available from: https://pubmed.ncbi.nlm.nih.gov/27123353/ doi: 10.1155/2016/9384974
Elnady B, Rageh EM, Hussein MS, Abu-Zaid MH, Desouky DES, Ekhouly T, et al. In shoulder adhesive capsulitis, ultrasound-guided anterior hydrodilatation in rotator interval is more effective than posterior approach: a randomized controlled study. Clin Rheumatol [Internet]. 2020 [cited 2020 Oct 20];39(12):3805-14. Available from: https://pubmed.ncbi.nlm.nih.gov/32385765/ doi: 10.1007/s10067-020-05131-2
Burkhart SS, Morgan CD, Ben Kibler W, “The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics. Arthroscopy [Internet]. 2003 [cited 2020 May 18];19(4):404-20. Available from: https://pubmed.ncbi.nlm.nih.gov/12671624/ doi: 10.1053/jars.2003.50128
Carette S, Moffet H, Tardif J, Bessette L, Morin F, Frémont P, et al. Intraarticular corticosteroids, supervised physiotherapy, or a combination of the two in the treatment of adhesive capsulitis of the shoulder: a placebo-controlled trial. Arthritis Rheum [Internet]. 2003 [cited 2020 Jan 22];48:829-38. Available from: https://onlinelibrary.wiley.com/doi/epdf/10.1002/art.10954 doi: 10.1002/art.10954
Rymaruk S, Peach C. Indications for hydrodilatation for frozen shoulder. EFORT Open Rev [Internet]. 2017 [cited 2022 Oct 18];22;2(11):462-8. Available from: https://pubmed.ncbi.nlm.nih.gov/29218231/ doi: 10.1302/2058-5241.2.160061
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