Frozen Shoulder Management with Hydro Dilatation Versus Steroid Injection

Abstract

Objective: To evaluate and compare the results of treatment of frozen shoulder by hydraulic distension and intra articular steroid injection with alone intra-articular steroid injection.
Methods: Clinical study comprising of two groups was carried out in the orthopedic department of services hospital, Lahore from Sept. 2013 to Dec. 2017. Patients were divided in 2 groups. Group-I was treated by hydraulic distention of gleno-humeral joint with 50 ml normal saline under local anesthesia with steroid followed by oral analgesics and muscle relaxants accompanied by exercises. Patients in group II were treated by intra-articular steroid injection followed by oral analgesics and muscle relaxants accompanied by exercises. Follow-up for both the groups was for 45 days, during the follow-up period both the groups reported pain relief, but patients in group II were unable to return to their normal activities due to less improvement in ROM.
Results: In Group 1 at the end of 45 days 25(86%) patients got complete resolution of pain while 4(14%) patients complained of occasional mild pain (VAS 3 or 4), In group-II 18(60%) patients got a complete resolution of pain while 12(40%), patients complained of occasional pain. The pain relief was statistically insignificant when compared between the two groups (p-values >0.05). The
improvement in the standard of living observed in group I patients was statistically significant as compared to group I, p-value<0.001. An immediate and remarkable improvement in range of movement (ROM) 46%-95% was observed in patients of group I as compared to group II. At the end of the 45 day there was marked difference in improvement in ROM 84% in group-I and 63% in Group-II. This difference was much significant (P-Value<0.001). Twenty six (90%) patients in group-I were satisfied with the treatment and 3(10%) were unsatisfactory, while in group-II only 10(33%) were satisfied and 20(67%) were not satisfied.
Conclusions: The study concluded that outcome of treatment of patients in group I was better and statistically significant than group II patients. It is further suggested that for quick, safe and earlier results