A Retrospective Study of Ultrasound-guided Hydrodilatation of Glenohumeral Joint Combined with Corticosteroid Injection in Patients with Frozen Shoulder

Objective: The purpose of this study was to establish the efficacy of ultrasound (US)-guided hydrodilatation of the glenohumeral joint, in conjunction with corticosteroid injection, in alleviating pain and improving shoulder joint adhesion among patients with primary frozen shoulder (FS). Background: FS, also known as adhesive capsulitis, is a pathological condition characterized by pain and potential functional impairment. The natural progression of FS involves three distinct stages: freezing, frozen, and thawing. Chronic pain in FS patients can lead to aseptic inflammation, thickening of fibroblasts, and an abundance of type I and III collagen fibers in the vicinity of the glenohumeral joint, ligaments, and tendons. This condition significantly impacts patients' quality of life. Methods: A total of 200 FS patients were enrolled in this study. All participants underwent US-guided hydrodilatation of the glenohumeral joint, combined with corticosteroid injection, at our department. Pre- and post-treatment (1 year) ultrasound measurements were recorded for the thickness of the axillary recess capsule (ARC), coracohumeral ligament (CHL), and subacromial bursa. Additionally, the numerical rating scale (NRS) and Constant-Murley score (CMS) were assessed to evaluate pain intensity and shoulder function, respectively. Results: Prior to the commencement of treatment, the measurements indicated a thickness of 4.8±2.3 mm for the ARC, 4.2±1.7 mm for the CHL, and 3.9±1.4 mm for the subacromial bursa. Additionally, the preoperative assessment using the NRS scale for pain yielded a score of 6.4±2.0, while the CMS score for the joint function was 35.8±8.5. Following one year of treatment, a notable decrease was observed in the thickness of ARC, CHL, and subacromial bursa. Furthermore, significant improvements were recorded in both the pain NRS score and the CMS score Conclusion: US-guided hydrodilatation of the glenohumeral joint, in combination with corticosteroid injection, may help improve the symptom and function of FS.