Indian Journal of Orthopaedics Surgery


Idiopathic Adhesive Capsulitis, results of single corticosteroid injection and exercises


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Author Details: Santosh Lakshmanrao Munde, Hemlata Thakurdas Kamra, Anil Dharampal Gulia, Sanjay Middha

Volume : 2

Issue : 4

Online ISSN : 2395-1362

Print ISSN : 2395-1354

Article First Page : 340

Article End Page : 343


Abstract

Introduction: Adhesive capsulitis of shoulder is associated with painful loss of range of motion (ROM).Many authors consider it as a self-limited condition, however it can persist for years & may not fully resolve. Pathologically, specimens show capsular hyperplasia along with fibrosis. The condition is more common in females and in diabetic patients. The optimal treatment of this condition is controversial, with varying degrees of success with different modalities of treatment.
Material and Methods: Fifty patients with idiopathic adhesive capsulitis were included in the study carried out at BPSGMC, Khanpur. Single intraarticular corticosteroid injection was given in each patient using posterior approach & the patients were put on a home based exercise program. The pre injection status of the patient was recorded and the patients were followed up till 6 months. The results were evaluated using VAS score, improvement in range of motion & a functional shoulder rating score. (L` Insalata et al.)
Results: Out of the 50 patients, 8 patients were lost to follow up & 12 patients did not recover as per the criteria. The average pre injection status of the patients in terms of VAS score, ROM & shoulder rating score were improved. The average recovery time was 14.2 weeks. Out of 12 patients who did not recover 7 opted for hydro dilatation, 3 opted for arthroscopic capsular release & 2 patients refused any intervention.
Discussion: The incidence of adhesive capsulitis is 3% in general population. Number of treatment options is available. Combination of intraarticular corticosteroid and an exercise programme provides a safe & effective method for treating this condition. There are many studies in literature which have compared the results of intraaricular steroid injection with physiotherapy and combination of both. The method is safe, cost effective and does not have major risks. The results of our study show that combination of a single dose of intraarticular steroid and physical exercises can form a first line of treatment in treatment of idiopathic adhesive capsulitis.
Conclusion: This simple method is effective and most of the patients will recover. With refinement of the technique like use of ultrasonogrphy results can be further improved. However a long term follow up is required before concluding the real efficacy of this method.

Keywords:
Adhesive capsulitis, Intrarticular steroids, Physical exercises, Frozen shoulder, Shoulder pain