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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_1 | Pages 47 - 47
1 Jan 2013
Clement R Ray A Davidson C Perks F Robinson M
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Distension arthrography of the glenohumeral joint was adopted as a mainstream treatment for adhesive capsulitis before any randomised controlled trials were performed. Interpretation of the effectiveness of this procedure rests on data from cohort studies of which there are few of high quality. Papers reporting on the long-term results have either excluded diabetic patients or failed to report on patient orientated outcomes.

We present a prospective cohort study of 51 patients with adhesive capsulitis of the shoulder who had a distension arthrogram performed by a single radiologist as a primary intervention. We included diabetic patients.

Range of movement (ROM), Oxford shoulder score (OSS) and a visual analogue pain score (VAS) were recorded pre-procedure, at 2 days and 1 month. OSS and VAS were recorded again at a mean of 14 months post procedure (range 8–26 months).

OSS improved from pre-procedure mean of 22.3 by 16.9 points at final follow up in September 2011 (p < 0.001) whilst VAS improved from a mean pre-procedure of 7.1 by −3.5 by September 2011 (p< 0.001). ROM improved with a mean increase of 39.3 degrees in flexion, 55.2 degrees in abduction and 19.5 degrees in external rotation by 1 month (p < 0.001 for all). The outcome in diabetic patients was the same as in non-diabetic patients.

We conclude that distension arthrography is a safe and effective treatment for adhesive capsulitis.