Can we improve the outcome of hydrodilatation for adhesive capsulitis?

Haughton, D.N.; Barton, Simon; Meenan, Erin; Mehan, Rakesh; Wykes, P.; Warner, James G.; Mulgrew, Emma

doi:10.1177/1758573217706199

Cited by 15 publications

(19 citation statements)

References 20 publications

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“…Andren and Lundberg40) first described hydrodistension (HD) in 1965 to treat the adhesive glenohumeral joint by expansion of the capsule. Although therapeutic regimens will differ, this technique is the installation of a large volume of saline, steroid, local anesthetic, and contrast agent into the glenohumeral joint under imaging guidance 414243). Most studies comment on a procedure to achieve capsular rupture but have not investigated this 4142).…”

Section: Conservative Treatmentmentioning

confidence: 99%

“…Although therapeutic regimens will differ, this technique is the installation of a large volume of saline, steroid, local anesthetic, and contrast agent into the glenohumeral joint under imaging guidance 414243). Most studies comment on a procedure to achieve capsular rupture but have not investigated this 4142). There is no evidence to determine whether capsule rupture must be achieved or whether capsular distension is most important.…”

Section: Conservative Treatmentmentioning

confidence: 99%

“…HD has been reported to provide short-term benefits regarding pain, ROM, and function in FS 41). Haughton et al42) reported results of HD in 76 patients with a mean follow-up of 3.5 months. The Oxford shoulder score improved from a mean of 20.6 preoperatively to a mean of 32.7 postoperatively.…”

Section: Conservative Treatmentmentioning

confidence: 99%

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Treatment Strategy for Frozen Shoulder

2019

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Frozen shoulder (FS) is a common shoulder disorder characterized by a gradual increase of pain of spontaneous onset and limitation in range of motion of the glenohumeral joint. The pathophysiology of FS is relatively well understood as a pathological process of synovial inflammation followed by capsular fibrosis, but the cause of FS is still unknown. Treatment modalities for FS include medication, local steroid injection, physiotherapy, hydrodistension, manipulation under anesthesia, arthroscopic capsular release, and open capsular release. Conservative management leads to improvement in most cases. Failure to obtain symptomatic improvement and continued functional disability after 3 to 6 months of conservative treatment are general indications for surgical management. However, there is no consensus as to the most efficacious treatments for this condition. In this review article, we provide an overview of current treatment methods for FS.

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Section: Conservative Treatmentmentioning

confidence: 99%

Section: Conservative Treatmentmentioning

confidence: 99%

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Treatment Strategy for Frozen Shoulder

2019

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“…Authors also noted JRPMS that the amount of volume injectate had no real effect on improvement. On the contrary, a retrospective study done by Haughton et al supports the use of hydrodilatation for adhesive capsulitis and states the amount of volume injectate does indeed influence the outcome 26 .…”

Section: Capsular Hydrodilatationmentioning

confidence: 94%

Current non-operative treatments for adhesive capsulitis: A Review

Chhatlani¹,

Oberle²,

Tekmyster³

2020

JRPMS

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This study aims to determine the best available non-operative approach for adhesive capsulitis and to create a guided treatment plan based on the research and evidence. An electronic search of multiple databases including PubMed, Cochrane Library, Wiley Online Library, Google Scholar, and Ovid Medline was completed. Search terms included “adhesive capsulitis”, “frozen shoulder”, “adhesive capsulitis treatments”, and “frozen shoulder treatments”. Exclusion criteria included articles that were published before the year 1984 and non-peer reviewed articles. Seventy-four articles were retrieved from the original search, and of those forty-nine articles were included and twenty-five were excluded. In the available research and literature, there is no clear consensus of one non-operative approach against the other. There is however clear evidence that intra-articular corticosteroid injections provide pain relief in the short term. There may be a role for the other non-operative interventions in the treatment for adhesive capsulitis but the current evidence does not support them being implemented as standalone treatment options. In order to determine the best available non-operative approach for adhesive capsulitis there is a need for higher quality randomized controlled trials moving forward. The available literature has limitations that would restrict one to formulate a consensus on a guided treatment plan.

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“…The proposed mechanism of action is the mechanical distension of the joint space, ideally rupturing the tight, fibrotic joint capsule that develops during AC. 6 Moreover, hydrodilatation is more cost-effective than common surgical intervention strategies, only costing approximately £280 compared to around £1440 and £2200 for manipulation under anaesthesia and arthroscopic capsular release, respectively. 8 This means a significantly lower economic burden on health-care providers and surgical waiting lists if similar outcomes can be achieved.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided hydrodilatation for adhesive capsulitis of the shoulder: A case series

Ainen

Sivan

2020

Journal of Orthopaedics, Trauma and Rehabilitation

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Adhesive capsulitis (AC) is a painful and debilitating condition of the glenohumeral joint and has been described as self-limiting. However, recent reports suggest that up to 40% of patients report persistent symptoms, therefore intervention strategies are needed to improve function and quality of life. One such intervention is the hydrodilatation of the glenohumeral joint with a high-volume injection, comprising of local anaesthetic, corticosteroid and normal saline, making a total volume of up to 40 ml. This service evaluation assessed the outcomes in 28 patients (23 females and 5 males; mean age 54.29 years) with AC who underwent ultrasound-guided (USG) hydrodilatation in a clinical outpatient setting. There was a statistically significant improvement in pain and all shoulder movements (all changes p value < 0.01). No adverse effects were encountered. Therefore, the USG glenohumeral joint hydrodilatation procedure in a clinical outpatient setting is a safe and effective intervention for AC.

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Can we improve the outcome of hydrodilatation for adhesive capsulitis?

Abstract: The present study supports the use of HD as a first line treatment for AC regardless of the underlying cause, and also demonstrates that the volume injected does appear to influence the outcome.

Cited by 15 publications

References 20 publications

Treatment Strategy for Frozen Shoulder

Treatment Strategy for Frozen Shoulder

Current non-operative treatments for adhesive capsulitis: A Review

Ultrasound-guided hydrodilatation for adhesive capsulitis of the shoulder: A case series

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