Sinha Rajendranath, Patel Priyesh, Rose Nicky, Tuckett John, Banerjee Anurag N, Williams John, Aldridge Stephen, Stuart Paul
Royal Victoria Infirmary, Newcastle Hospitals NHS Trust, Newcastle upon Tyne, UK.
Freeman Hospital, Newcastle Hospitals NHS Trust, Newcastle upon Tyne, UK.
Shoulder Elbow. 2017 Jul;9(3):169-177. doi: 10.1177/1758573216687273. Epub 2017 Jan 29.
Adhesive capsulitis is a common cause of stiff shoulder and may result in pain and restriction of movement. The study aimed to investigate the role of hydrodilatation of the glenohumeral joint in the management of adhesive capsulitis.
Patients referred from the shoulder clinic underwent hydrodilatation under ultrasound guidance. Of 209 referred for hydrodilatation, 163 underwent the procedure and attended follow-up physiotherapy. Outcome measures were available for 118 patients (58 men and 60 women). Mean age of the study group was 52.6 years.
There was a statistically significant improvement in both Oxford Shoulder Score (OSS) and Disability Arm Shoulder Hand Scores (Quick DASH) in the first 4 weeks after the procedure, which was maintained but not improved to the end of the study period. Patients presenting with pain, those who had a history of steroid injections and older patients all had worse functional scores at presentation. Diabetes (both Type I and II), previous physiotherapy, length of history and whether pain or stiffness, or both, were the predominant symptom did not have any statistical significance at presentation. These factors were not predictors of any statistically significant improvement in functional scores.
Hydrodilatation results in a significant improvement of symptoms in patients with adhesive capsulitis.
粘连性关节囊炎是肩关节僵硬的常见原因，可能导致疼痛和活动受限。本研究旨在探讨肱盂关节液压扩张术在粘连性关节囊炎治疗中的作用。
从肩关节诊所转诊的患者在超声引导下接受液压扩张术。在209名转诊接受液压扩张术的患者中，163名接受了该手术并参加了后续物理治疗。118名患者（58名男性和60名女性）有可用的结果指标。研究组的平均年龄为52.6岁。
术后前4周，牛津肩关节评分（OSS）和上肢、肩部和手部功能障碍评分（快速DASH）均有统计学意义的改善，且这种改善在研究期结束时得以维持，但未进一步改善。出现疼痛的患者、有类固醇注射史的患者以及老年患者在就诊时的功能评分均较差。糖尿病（I型和II型）、既往物理治疗、病程长短以及疼痛或僵硬或两者均为主要症状在就诊时均无统计学意义。这些因素并非功能评分有统计学意义改善的预测因素。
液压扩张术可使粘连性关节囊炎患者的症状得到显著改善。
