Comparison of effi cacy of intra articular steroid injection versus hydrostatic shoulder distention in idiopathic frozen shoulder

Abstract

Introduction: Th e term frozen shoulder was fi rst used in 1934 by Codman, who described the common features of a slow onset of pain felt near the insertion of the deltoid muscle, inability to sleep on the aff ected side, and restriction in both active and passive elevation and external rotation, yet with a normal radiological appearance. Th is study will also provide local statistics for effi cacy of the intra-articular steroid injection and hydrostatic distension and if any modality found to be signifi cantly high, we will disseminate the results with other local orthopedic surgeons and will suggest its routine use in the treatment of idiopathic frozen shoulder. Th e study will also form a basis for further research. Objective: To compare the effi cacy of intra articular steroid injection versus hydrostatic shoulder distention in idiopathic frozen shoulder. Sett ing: Department of Orthopedic Surgery, Khyber Teaching Hospital, Peshawar. Study design: Randomized Control Trail Duration of study: 6 months 2nd February, 2018 to 2nd August, 2018. Material and Methods: In this study a total sample size is 142. (71 in each group) were observed. Patients in group-A were injected this solution (steroid+Lignocaine) intra-articularly and in patients in Group B with 10ml Distilled water, by anterior approach (with the needle passing through the deltopectoral groove and then below and medial to the tip of the coracoid process, through the coracobrachialis – biceps origin and subscapularis) (with a 21 gauge x 1.5” needle). All patients of both groups then would have active and assisted range of motion exercises under supervision of a physiotherapist for 3-days and once the exercises are learnt by the patient, then the patient was allowed to do these exercises at home. Patients were reassessed at 6-weeks follow up to determine intervention eff ectiveness in terms of decrease in at least one grade of pain on Visual Analouge Scale and increase in range of motion of shoulder joint more than 20 degrees on gonometer. Results: In this study mean age in group-A was 38 years with SD±10.53 while mean age in group-B was 40 years with SD ± 9.48. In Group A 42% patients were male and 58% patients were female. While in group-B 40% patients were male and 60% patients were female. More over group-A (Intra articular steroid infection) was eff ective in 93% patients while group-B (Hydrostatic Distention) was eff ective in 87% patients. Conclusion: Our study concludes that Intra-articular steroid is more eff ective than hydrostatic distention for idiopathic frozen shoulder.