Arthrographic Hydrodilatation/Distension for Frozen Shoulder

Authors: C Manning, P Wright, L Funk

Purpose: To evaluate the efficacy of arthrographic hydrodilatation for the treatment of frozen shoulder over a three year period.

Methods: Fifty one patients were prospectively followed for a mean period of eight months. Patients were evaluated using the Constant and Oxford scoring systems, pain and patient satisfaction scores were recorded. Hydrodilatation was performed by three consultant musculoskeletal radiologists using a standardised technique. Consent and ethical approval was obtained.

Results: In thirty patients with primary (idiopathic) frozen shoulder the mean Constant score improved from 24 points to 83 points at final follow up. The mean Oxford score improved from 25 points to 44 points. Flexion improved from 53° to 154°, abduction from 34° to 143°, external rotation from 0° to 38°, internal rotation improved from the buttock to T12. The pain score improved from 9/10 to 2/10 at six weeks and 1/10 at final follow up.
Five patients in this group underwent subsequent arthroscopic capsular release.

In twenty one patients with secondary frozen shoulder, the mean Oxford score improved from 27 points to 40 points at final follow up, the Constant score improved from 31 points to 73 points at final follow up. Flexion improved from 66° to 159°, abduction from 49° to 154°, external rotation from 8° to 45° and internal rotation from the buttock to T12. The pain score improved from a mean 8/10 to 3/10 at six weeks and 2/10 at final follow up.
Two patients in this group required arthroscopic release for ongoing stiffness.

There were no complications of the procedure in either group.

Conclusion: Arthrographic hydrodilation is a safe and effective intervention for both primary and secondary frozen shoulder.