Abstract

Objectives

To assess the benefit offered by capsular hydrodilatation in addition to intra-articular steroid injections in cases of adhesive capsulitis, assess outcomes in diabetic patients with capsular hydrodilatation as compared to non-diabetics and correlate duration of symptoms with outcome based on the type of intervention given.

Materials and methods

This prospective double-blinded randomized control trial included patients presenting with clinical features of adhesive capsulitis with no evidence of rotator cuff pathology and randomized them into two groups—intra-articular steroid with hydrodilatation (distension group) and only intra-articular steroid (non-distension group) with intervention being performed as per the group allotted. Primary outcome measure was Shoulder Pain and Disability Index (SPADI) scores which were taken pre-intervention, at 1.5, 3 and 6 months post-intervention, which were assessed by generalized linear model statistics and Pearson correlation.

Results

Although there was statistically significant drop in SPADI in both groups over time [F(1.9, 137.6) = 112.2; p < 0.001], mean difference in SPADI between the 2 groups was not statistically significant (1.53; CI:-3.7 to 6.8; p = 0.56). There was no significant difference between both groups among diabetics [F(1,38) = 0.04; p = 0.95] and no significant difference between diabetic and non-diabetic patients who received hydrodilatation [F(1.8, 60) = 2.26; p = 0.12]. There was no significant correlation between the reduction in SPADI scores and duration of symptoms in any subset of the study population.

Conclusion

Shoulder joint hydrodilatation offered no additional benefit compared to intra-articular steroid injections for shoulder adhesive capsulitis. Outcome for diabetics and non-diabetics were similar and there was no correlation between duration of symptoms and outcome.

中文翻译：

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关节内类固醇用于粘附性囊膜炎：加氢扩张还会带来其他好处吗？随机对照试验

摘要

目标

为了评估在粘附性囊膜炎的情况下，除了关节内类固醇注射外，囊状囊扩张术还能带来的益处，评估与非糖尿病患者相比，囊状囊扩张术的糖尿病患者的结局，并根据所给予的干预类型将症状持续时间与结局相关联。

材料和方法

这项前瞻性双盲随机对照试验包括表现为黏膜囊膜炎的临床特征且无肩袖病理的患者，并将其随机分为两组-关节腔内类固醇扩张症（扩张组）和仅关节内类固醇（非扩张性）。扩张组），并根据分配的组进行干预。主要结局指标为干预前1.5、3和6个月在干预前，均通过广义线性模型统计和Pearson相关性评估的肩痛和残疾指数（SPADI）评分。

结果

尽管两组间SPADI的下降均具有统计学意义[ F（1.9，137.6 ）= 112.2; p  <0.001]，两组之间SPADI的平均差异无统计学意义（1.53； CI：-3.7至6.8；p  = 0.56）。两组之间糖尿病患者之间无显着性差异[ F（1,38）= 0.04; p  = 0.95]，接受水扩张术的糖尿病和非糖尿病患者之间无显着差异[ F（1.8，60 ）= 2.26; p  ＝ 0.12]。在研究人群的任何子集中，SPADI得分的降低与症状持续时间之间没有显着相关性。

结论

与关节内类固醇激素注射相比，肩关节加氢扩张无额外益处。糖尿病患者和非糖尿病患者的结果相似，症状持续时间与预后之间没有相关性。