Explore the efectiveness of fluoroscopic-guided hydrodilatation of glenohumeral joint for the treatment of frozen shoulder

Nguyen Thi Thu Hang1,, Vu Long2, Nguyen Duy Trinh2, Pham Manh Cuong3, Tran Van Luong2, Tran Anh Tuan2, Pham Minh Thong4
1 Bach Mai Hopital
2 Bach Mai Hospital
3 Bạch Mai Hospital
4 Hội Điện quang và Y học hạt nhân Việt Nam

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Abstract

Objective: The objective was to explore the efectiveness of fluoroscopic-guided hydrodilatation of glenohumeral joint for the treatment of frozen shoulder
Materials and Methods: The prospective study 38 shoulders withprimary adhesive capsulitis were treated with hydrodilatation between August
2017 and July 2020 in Radiology Centre- Bach Mai Hospital. The patient were hydrodilatation with corticosteroid injection performed via an anterior
approach under fluoroscopy. Patients were followed up at baseline and at 2 and 4 weeks postintervention with Shoulder Pain and Disability Index (SPADI)
scores, VAS scores, and ROM in abduction, forward flexion, external rotation.
Results: A total of 38 consecutive patients with frozen shoulder underwent a distension arthrogram. There were 20 females and 18 males with a mean age of 59,6 (range : 43-91). The mean visual analogue pain score pre-distension was 6,1, two weeks and four weeks post-distension the mean score had significantly improved to 4,1 and 2,9. Mean baseline SPADI score for the patients pre-distension was 65, two weeks and four weeks post-distension the mean score had significantly improved to 45 and 32. Flexion improved from a mean of 76 degrees pre-distension with 106 degrees at 2 weeks and with 131 degrees at 4 weeks. Abduction improved from a mean of 75 degrees pre-distension with 107 degrees at 2 weeks and with 133 degrees at 4 weeks. External rotation improved from 20 degrees pre-distension with 36 degrees at 2 weeks and 53 degrees at 4 weeks. The patients receiving hydrodilatation demonstrated significant improvement in VAS scores and ROM in flexion, abduction, and external rotation at 8 weeks. No patient suffered any significant complication from hydrodilatation and, in particular, there were no intra-articular infections.
Conclusion: Review of the literature and the results presented here indicate that arthrographic capsular distension progressing using fluid containing cortisone is a fairly effective treatment for adhesive capsulitis. Distension arthrography seems to he a promising treatment for adhesive capsulitis. Arthrographic shoulder capsule distension was performed through an anterior-lateral approach under fluoroscopic guidance is accurate, reliable and minimally invasive.

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References

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