title: Clinical efficacy of hydrodistention with joint manipulation under interscalene block compared with intra-articular corticosteroid injection for frozen shoulder: a prospective randomized controlled study.
abstract: BACKGROUND
  Hydrodistention is known to be an effective method of treatment for frozen shoulder. However, hydrodistention is accompanied by severe pain during the procedure. An interscalene block may relieve the severe pain associated with the procedure of hydrodistention. This study compared the clinical efficacy of hydrodistention with joint manipulation under an interscalene block with that of intra-articular corticosteroid injection.
  
  
  METHODS
  This prospective randomized controlled study included 121 patients presenting with frozen shoulder. Patients were randomized into 2 groups; those in group A (60 patients) were treated by hydrodistention with joint manipulation under an interscalene block, and those in group B (61 patients) were managed with intra-articular corticosteroid injection. Pain intensity and patient satisfaction were assessed by the visual analog scale. Functional outcomes were assessed by the Constant score and the range of shoulder motion.
  
  
  RESULTS
  Group A demonstrated better patient satisfaction and earlier restoration of range of motion than group B at 6 weeks (P ≤ .001). At 12 weeks, the pain score was lower and the Constant score was better in group A than in group B. However, at 12 months after treatment, pain score (P = .717), patient satisfaction (P = .832), range of motion (P > .05), and Constant score (P = .480) were similar in the 2 groups.
  
  
  CONCLUSIONS
  Hydrodistention combined with joint manipulation under an interscalene block provided earlier pain relief and restoration of shoulder range of motion and function compared with single intra-articular corticosteroid injection in patients with primary frozen shoulder.
authors: Department of Orthopaedic Surgery, Yeosu Baek Hospital, Yeosu-si, Republic of Korea.
authors: Sang Won
authors: SW
authors: Mun
authors: Department of Orthopaedic Surgery, Yeosu Baek Hospital, Yeosu-si, Republic of Korea. Electronic address: Ch100c@chol.com.
authors: Chang Hee
authors: CH
authors: Baek
mesh_terms: D002062:Bursitis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008349:Manipulation, Orthopedic; D008875:Middle Aged; D009407:Nerve Block; D017060:Patient Satisfaction; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000503:physiopathology*; D014221:Triamcinolone / Q000627:therapeutic use*; D064232:Visual Analog Scale
chemical_list: D005938:Glucocorticoids; D014221:Triamcinolone
keywords: Hydrodistention; adhesive capsulitis; corticosteroid injection; frozen shoulder; interscalene block; manipulation