Comparison of treatment modalities for Adhesive Capsulitis steroid injection vs Hydrodilatation with steroid injection

Objective: To compare the effectiveness of hydrodilatation with steroids injection versus only steroid injections in the treatment of adhesive capsulitis. Study Design: Prospective comparative study. Place and Duration: This study was conducted at the Department of Orthopaedic Surgery, PAEC General Hospital, Islamabad from 13th Sep 2023 to 12th Feb 2024. Methodology: A total of 54 patients were included in the study. The participants were divided into two groups. Group A participants were given steroid injections only while Group B participants were given steroid injections with hydrodilatation. Pain score was calculated by visual analogue score as 0 being no pain and 10 being the highest degree of pain after injection. Data analysis was done on SPSS version 25.0. Shapiro-Wilk test was performed to analyze whether data follow normal distribution. A p-value ≤0.05 was taken as significant. Results: The Shoulder Pain and Disability Index scores (SPADI) were assessed prior to the intervention, as well as at the two-week, six-week and three-month intervals post-intervention. There was no statistically substantial variation in SPADI scores between the groups two weeks after the injection with p-value of 0.34, however, at 6 weeks (p=0.04) and 3 months (p=0.01) a significant variation in SPADI score was demonstrated with better scores in Group B patients. Conclusion: Our study concluded that the group that received corticosteroids with hydrodilatation showed improved clinical outcomes after six weeks and three months. They also needed less pain medication after the treatment. Consequently, using intra-articular steroid injections with hydrodilatation appears to be a preferable approach for managing adhesive capsulitis during the frozen phase, compared to intra-articular steroid injection alone.