Comparative Effectiveness of Corticosteroid Dosages for Ultrasound-Guided Glenohumeral Joint Hydrodilatation in Adhesive Capsulitis: A Randomized Controlled Trial

Objective: To investigate the efficacy of hydrodilatation with 40 mg triamcinolone acetonide (TA) compared with the same procedure with 10 mg TA in patients with adhesive capsulitis (AC) of the shoulders.Design: Prospective, double-blind, randomized controlled trial with 12 weeks of follow-up.Setting: Tertiary care rehabilitation center. Participants: Eighty-four patients diagnosed with AC (N=84).Interventions: Ultrasound guidance using (A) hydrodilatation with 4 mL of TA (40 mg)+4 mL 2% lidocaine hydrochloride+12 mL normal saline or (B) hydrodilatation with 1 mL of TA (10 mg)+4 mL 2% lidocaine hydrochloride+15 mL normal saline through the posterior glenohumeral recess.Main Outcome Measures: Shoulder Pain and Disability Index (SPADI), visual analog scale (VAS) for pain, and range of motion (ROM) at base-line and at 6 and 12 weeks after injection.Results: Both groups experienced improvements in the SPADI score, VAS scores for pain, and ROM throughout the study period. However, group-by -time interactions were not significant for any outcome measurement at any follow-up time point. No adverse events were reported in either group.Conclusion: Ultrasound-guided hydrodilatation with 40 and 10 mg TA yielded similar improvements in SPADI, VAS score, and ROM at the 12 -week follow-up. Considering the potential detrimental effects of corticosteroids on the adjacent cartilage and tendons, a low dose of TA would be preferable for ultrasound-guided hydrodilatation for AC.Archives of Physical Medicine and Rehabilitation 2023;104:745-52 (c) 2022 by the American Congress of Rehabilitation Medicine.