Simplified, single-shot, capsule-preserving hydrodilatation combined with corticosteroids versus isolated corticosteroid injection for adhesive capsulitis: a randomized controlled trial
4 affiliations
- 1Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-Si, Gyeonggi-Do Korea
- 2Department of Orthopaedic Surgery, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon-Si Gangwon-Do, Korea
- 3Department of Pathology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon-Si, Gangwon-Do Korea
- 4Department of Diagnostic Radiology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon-Si, Gangwon-Do Korea
Abstract
Background: Glenohumeral corticosteroid injection has been a major treatment for adhesive capsulitis of the shoulder. Hydrodilatation is also a treatment option. However, few studies have considered the combined treatment of the two methods with heterogeneous protocols and results. The purpose of this study is to investigate the additional effect of hydrodilatation for glenohumeral corticosteroid injection in adhesive capsulitis of the shoulder involving a streamlined process.
Methods: Sixty-two patients were randomized in this randomized controlled trial. Of these, 50 patients were included in the final per-protocol analysis: 24 in group CS and 26 in group CSHD. Group CS received a single ultrasound-guided glenohumeral injection with 1 mL (40 mg) triamcinolone and 4 mL lidocaine. Group CSHD received the same injection with an additional 15 mL of saline. Capsular distension without intended rupture was assessed using ultrasound, and the capsule-humeral head distance was measured. Pain visual analog scale, patient satisfaction, range of motion (ROM) in forward elevation and internal/external rotation, American Shoulder and Elbow Surgeons (ASES) score, and Constant score were assessed before injection and at 3 weeks, 7 weeks, 3 months, and 6 months after injection.
Results: The baseline data were similar between the groups. After injection, the CSHD group demonstrated a significantly greater capsule-humeral head distance on ultrasound (p < 0.001). Significant improvement was demonstrated within each group after 6 months (p < 0.001 in all parameters). However, compared to group CS, group CSHD showed a greater increase in the ASES score as early as week 3 (p < 0.001) and in ROM as early as week 7 (p < 0.050 in all directions). At the last follow-up at 6 months, group CSHD showed significantly better results in ROM (p < 0.005 in all directions), patient satisfaction (p = 0.004), ASES (p = 0.040), and Constant scores (p = 0.011) than group CS.
Conclusion: In treating adhesive capsulitis, adding saline to a conventional corticosteroid injection to perform a single-shot, capsule-preserving hydrodilatation with a 20 mL solution may improve short- to mid-term functional recovery compared to an isolated corticosteroid injection.
Trial registration: ClinicalTrials.gov identifier NCT06493656 (Retrospectively registered July 7, 2024).
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13018-026-07215-2.
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BibTeX
@article{kim2026simplified,
title = {{Simplified, single-shot, capsule-preserving hydrodilatation combined with corticosteroids versus isolated corticosteroid injection for adhesive capsulitis: a randomized controlled trial}},
author = {Yong Tae Kim and Jung-Taek Hwang and Sang Hak Han and Myung-Sun Hong and Jun-Beom Lee},
journal = {Journal of Orthopaedic Surgery and Research},
year = {2026},
month = sep,
doi = {10.1186/s13018-026-07215-2},
url = {https://doi.org/10.1186/s13018-026-07215-2},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Simplified, single-shot, capsule-preserving hydrodilatation combined with corticosteroids versus isolated corticosteroid injection for adhesive capsulitis: a randomized controlled trial
AU - Yong Tae Kim
AU - Jung-Taek Hwang
AU - Sang Hak Han
AU - Myung-Sun Hong
AU - Jun-Beom Lee
PY - 2026
DA - 2026/09/06
JO - Journal of Orthopaedic Surgery and Research
DO - 10.1186/s13018-026-07215-2
UR - https://doi.org/10.1186/s13018-026-07215-2
AB - Background: Glenohumeral corticosteroid injection has been a major treatment for adhesive capsulitis of the shoulder. Hydrodilatation is also a treatment option. However, few studies have considered the combined treatment of the two methods with heterogeneous protocols and results. The purpose of this study is to investigate the additional effect of hydrodilatation for glenohumeral corticosteroid injection in adhesive capsulitis of the shoulder involving a streamlined process. Methods: Sixty-two patients were randomized in this randomized controlled trial. Of these, 50 patients were included in the final per-protocol analysis: 24 in group CS and 26 in group CSHD. Group CS received a single ultrasound-guided glenohumeral injection with 1 mL (40 mg) triamcinolone and 4 mL lidocaine. Group CSHD received the same injection with an additional 15 mL of saline. Capsular distension without intended rupture was assessed using ultrasound, and the capsule-humeral head distance was measured. Pain visual analog scale, patient satisfaction, range of motion (ROM) in forward elevation and internal/external rotation, American Shoulder and Elbow Surgeons (ASES) score, and Constant score were assessed before injection and at 3 weeks, 7 weeks, 3 months, and 6 months after injection. Results: The baseline data were similar between the groups. After injection, the CSHD group demonstrated a significantly greater capsule-humeral head distance on ultrasound (p < 0.001). Significant improvement was demonstrated within each group after 6 months (p < 0.001 in all parameters). However, compared to group CS, group CSHD showed a greater increase in the ASES score as early as week 3 (p < 0.001) and in ROM as early as week 7 (p < 0.050 in all directions). At the last follow-up at 6 months, group CSHD showed significantly better results in ROM (p < 0.005 in all directions), patient satisfaction (p = 0.004), ASES (p = 0.040), and Constant scores (p = 0.011) than group CS. Conclusion: In treating adhesive capsulitis, adding saline to a conventional corticosteroid injection to perform a single-shot, capsule-preserving hydrodilatation with a 20 mL solution may improve short- to mid-term functional recovery compared to an isolated corticosteroid injection. Trial registration: ClinicalTrials.gov identifier NCT06493656 (Retrospectively registered July 7, 2024). Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13018-026-07215-2.
SN - 1749-799X
ER -