A randomized controlled trial of arthroscopic capsular release versus hydrodilatation in the treatment of primary frozen shoulder

Gallacher, Sian; Beazley, James; Evans, Jonathan P; Anaspure, Rahul; Silver, David; Redfern, Andrew; Thomas, William J.; Kitson, J.; Smith, Chris

doi:10.1016/j.jse.2018.04.002

Cited by 40 publications

(44 citation statements)

References 15 publications

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“…7,8 Glenohumeral hydrodilation has shown mixed results and as such is typically not a routine part of the treatment algorithm for adhesive capsulitis. 9,10 Because adhesive capsulitis often resolves without surgical intervention, a prolonged course of nonoperative management is offered in an attempt to avoid surgical intervention. Although many physicians offer corticosteroid injections because they have been shown to help with symptoms, there are limited data on the number of corticosteroid injections that should be provided during the course of conservative treatment to afford the maximum benefit to the patient.…”

mentioning

confidence: 99%

Adhesive Capsulitis: Demographics and Predictive Factors for Success Following Steroid Injections and Surgical Intervention

Erickson

Shishani

Bishop

et al. 2019

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: Examine demographic factors of all patients treated for adhesive capsulitis by a single surgeon, report the treatments and outcomes of these patients, and determine the effectiveness of various treatments, including corticosteroid injections and operative intervention in relation to risk factors for adhesive capsulitis. Methods: All patients treated for adhesive capsulitis by a single surgeon between 2008 to 2014 with minimum 2 years' follow-up were identified via charts and operative reports and were eligible for inclusion. Demographic information including sex and medical comorbidities was documented. Preintervention and postintervention shoulder range of motion was recorded. Specific treatment information (number of corticosteroid injections, etc) was collected. Treatment outcomes were then compared as an aggregate and among varying comorbidities. Results: Overall, 1377 patients were treated for adhesive capsulitis (946 women vs 431 men [P ¼ .001]). For patients with adhesive capsulitis: a higher percentage of men than women had diabetes (24.8% vs 17.3% [P ¼ .001]); nondiabetic patients had better forward flexion at initial presentation than patients with diabetes (114 vs 108 [P ¼ .015]); more patients with diabetes required capsular release than nondiabetic patients (13% vs 7.3% [P ¼ .003]); more nondiabetic patients resolved adhesive capsulitis without corticosteroid or surgical intervention than patients with diabetes (83.6% vs 61.7% [P ¼ .001]); more nondiabetic patients resolved adhesive capsulitis after single corticosteroid injection than did patients with diabetes (95.9% vs 86.7% [P ¼ .001]). Multiple intraarticular corticosteroid injections provided no added benefit over a single injection in resolving adhesive capsulitis in patients with diabetes and nondiabetic patients. Conclusion: In shoulder adhesive capsulitis, women and patients with diabetes are more commonly affected, patients with diabetes respond less favorably to physical therapy in isolation and physical therapy plus corticosteroid injections than nondiabetic patients. No benefit from multiple intraarticular corticosteroid injections was seen compared with a single intraarticular corticosteroid injection in patients with diabetes and nondiabetic patients. Patients with diabetes and nondiabetic patients have functional improvement after capsular release and manipulation if conservative treatment for adhesive capsulitis fails. Level of Evidence: III, case control.

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confidence: 99%

Adhesive Capsulitis: Demographics and Predictive Factors for Success Following Steroid Injections and Surgical Intervention

Erickson

Shishani

Bishop

et al. 2019

Arthroscopy, Sports Medicine, and Rehabilitation

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“…Finally, only 6% of UK practitioners were using hydrodilatation when we sur veyed practice to inform the design of UK FROST and consequently, this was not identified as a priority intervention for evaluation. 10 Its popularity has increased since then, and although recent small trials have compared hydrodilatation with manipulation, capsular release, and intra-articular steroid injections, 33,34 evidence of its effectiveness is inconclusive.…”

Section: Discussionmentioning

confidence: 99%

Muscle stiffness, gait instability, and liver cirrhosis in Wilson's disease

et al. 2020

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“…De Carli et al showed that arthroscopic arthrolysis, combined with mobilisation under anaesthesia, led to faster improvement in symptoms than intra-articular corticosteroid injection [53]. Gallacher et al compared 50 prospectively randomised patients undergoing arthroscopic capsular release or hydrodilatation and showed that both methods led to a rapid improvement in functional results but that the results in the arthroscopic capsular release group were significantly better after 6 months [54].…”

Section: Surgical Treatmentmentioning

confidence: 99%

Shoulder Stiffness – How to Treat?

et al. 2019

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Shoulder stiffness is a condition of restricted glenohumeral range of motion, which can arise spontaneously or as consequence of a known cause, including surgical procedures on the shoulder. Several approaches to shoulder stiffness have been proposed and high-level evidence is available to analyze and discuss their results. The aim of this review was to summarize the current concepts on conservative and operative treatment of shoulder stiffness and discuss the results of the available studies with a high level of evidence, which should be considered to guide clinical practice. Treatment of shoulder stiffness should be tailored to the patientʼs clinical situation and the stage of its shoulder pathology and should aim at pain reduction, restoration of range of motion, functional regain and shortening of symptoms duration. When possible, known risk factors for primary shoulder stiffness and causes of secondary shoulder stiffness should be addressed to avoid relapse. Conservative therapy is the mainstay of treatment for shoulder stiffness and should include a multimodal and activity-oriented program. Intra-articular injection of a low dose of corticosteroid is safe and effective, provides immediate benefits, and is recommended in combination to an appropriate rehabilitation protocol. In conservative refractory cases, arthrolysis and capsular release can be performed with an arthroscopic approach.

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A randomized controlled trial of arthroscopic capsular release versus hydrodilatation in the treatment of primary frozen shoulder

Cited by 40 publications

References 15 publications

Adhesive Capsulitis: Demographics and Predictive Factors for Success Following Steroid Injections and Surgical Intervention

Adhesive Capsulitis: Demographics and Predictive Factors for Success Following Steroid Injections and Surgical Intervention

Muscle stiffness, gait instability, and liver cirrhosis in Wilson's disease

Shoulder Stiffness – How to Treat?

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