Comparison Intra Articular Steroid vs. Hydraulic Distention for the Treatment of Frozen Shoulder

Background Frozen shoulder is a chronic fibrosing condition of the capsule of the shoulder joint. OBJECTIVE The objective of the study was to compare the result of treatment of frozen shoulder by Hydraulic Distention under local anesthesia with steroid and intra articular steroid alone. Sample Size: 60 patients were taken in this study and were divided into two groups. Duration and Setting: The study was conducted in 2005-2006 treated in the department of orthopaedic, Janaki medical college Teaching Hospital, Janakpur. Materials and Methods: It was a prospective, observational, comparative and clinical study. Sixty patients were selected from Dhanusha District of Janakpur, Nepal. They were divided into two groups. Since January 2005 to January 2006 periods in the department of orthopedics surgery, Janaki Medical College & Teaching Hospital, Janakpur. The Group I was treated by hydraulic distention of glenohumeral joint with 50ml normal saline with steroid, oral medicines (analgesics and muscle relaxants) and exercises. Patients in group II were treated by intra-articular steroid followed by oral medicines (analgesics and muscle relaxants) and exercises. Results: The average age of patients in group I was 52 ± 2.16 years and 50 ± 2.03 in group II. There were 37 (63%) females and 23 (37%) males in our study. Female to male ratio was 1.7:1. All patients in group noted immediate pain relief with excellent return of range of motion (ROM) and resumption of normal sleep. At the end of 45 days of follow up all patients had returned to their normal daily activities. Most of them got excellent ROM and pain relief. All patients in group II noted immediate pain relief and resumption of almost normal sleep. At the end of 45 days of follow up most of the patient presented with good relief of pain but could not return to most of their normal activities because of less improvement in ROM. Conclusions: Hydraulic distension technique is quick, safe and gives early results, so it should be considered first for the treatment of frozen shoulder. DOI: http://dx.doi.org/10.3126/jucms.v1i1.8415 Journal of Universal College of Medical Sciences Vol.1(1) 2013: 3-9

[1]  P. Anthony,et al.  The pathology of frozen shoulder. A Dupuytren-like disease. , 1995, The Journal of bone and joint surgery. British volume.

[2]  W. Sanders,et al.  Recalcitrant chronic adhesive capsulitis of the shoulder. , 1990, The Journal of bone and joint surgery. American volume.

[3]  J. Wolf,et al.  Influence of Comorbidity on Self-Assessment Instrument Scores of Patients with Idiopathic Adhesive Capsulitis , 2002, The Journal of bone and joint surgery. American volume.

[4]  N. Rydell,et al.  Combination treatment for adhesive capsulitis of the shoulder. , 1992, Clinical orthopaedics and related research.

[5]  A. Gam,et al.  Treatment of "frozen shoulder" with distension and glucorticoid compared with glucorticoid alone. A randomised controlled trial. , 1998, Scandinavian journal of rheumatology.

[6]  B. V. van Royen,et al.  Treatment of frozen shoulder by distension and manipulation under local anaesthesia , 1996, International Orthopaedics.

[7]  D. O. Fareed,et al.  Office management of frozen shoulder syndrome. Treatment with hydraulic distension under local anesthesia. , 1989, Clinical orthopaedics and related research.

[8]  J. Tibone,et al.  Frozen shoulder. A long-term follow-up. , 1992, The Journal of bone and joint surgery. American volume.

[9]  R. Pinals,et al.  Corticosteroid injections in adhesive capsulitis: investigation of their value and site. , 1991, Archives of physical medicine and rehabilitation.

[10]  C. Constant,et al.  A clinical method of functional assessment of the shoulder. , 1987, Clinical orthopaedics and related research.

[11]  D. Hamblen,et al.  Expression of growth factors, cytokines and matrix metalloproteinases in frozen shoulder , 2000 .

[12]  J. Bland,et al.  The painful shoulder. , 1977, Seminars in arthritis and rheumatism.