Hydrodilatation, corticosteroids and adhesive capsulitis: a randomized controlled trial.
BACKGROUND
Hydrodilatation of the glenohumeral joint is by several authors reported to improve shoulder pain and range of motion for patients with adhesive capsulitis. Procedures described often involve the injection of corticosteroids, to which the reported treatment effects may be attributed. Any important contribution arising from the hydrodilatation procedure itself remains to be demonstrated.


METHODS
In this randomized trial, a hydrodilatation procedure including corticosteroids was compared with the injection of corticosteroids without dilatation. Patients were given three injections with two-week intervals, and all injections were given under fluoroscopic guidance. Outcome measures were the Shoulder Pain and Disability Index (SPADI) and measures of active and passive range of motion. Seventy-six patients were included and groups were compared six weeks after treatment. The study was designed as an open trial.


RESULTS
The groups showed a rather similar degree of improvement from baseline. According to a multiple regression analysis, the effect of dilatation was a mean improvement of 3 points (confidence interval: -5 to 11) on the SPADI 0-100 scale. T-tests did not demonstrate any significant between-group differences in range of motion.


CONCLUSIONS
This study did not identify any important treatment effects resulting from three hydrodilatations that included steroid compared with three steroid injections alone.


BACKGROUND
The study is registered in Current Controlled Trials with the registration number ISRCTN90567697.
Tveitå
Einar Kristian
EK
Department of Physical Medicine and Rehabilitation, Ullevål University Hospital, Oslo, Norway. e.k.tveita@medisin.uio.no
Tariq
Rana
R
Sesseng
Sølve
S
Juel
Niels Gunnar
NG
Bautz-Holter
Erik
E
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001175:Arthrography / Q000009:adverse effects / Q000379:methods*; D002062:Bursitis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D004106:Dilatation; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016059:Range of Motion, Articular; D020069:Shoulder Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide