Outcomes of Fluoroscopic-Guided Hydrodilatation for Frozen Shoulder: A Prospective Study

Background and Aim: Frozen shoulder (adhesive capsulitis) is a disabling condition marked by severe pain and restricted movement in the shoulder joint, often leading to functional impairment. Hydrodilation, a minimally invasive procedure where fluid is injected into the joint under pressure, is a treatment option that aims to improve shoulder mobility and reduce pain. This study aims to evaluate the outcomes of Hydrodilation in terms of pain relief, functional improvement, and psychological impact in patients with frozen shoulder. Methodology: In this prospective study, 30 patients diagnosed with primary or secondary frozen shoulder were enrolled and underwent Hydrodilation using a saline solution mixed with local anaesthetic agent (0.5% Bupivacaine 5 ml), performed under fluoroscopic guidance. Clinical assessments were performed at baseline (pre-operative), 1 month and 3 months post-procedure. Outcome measures included the Visual Analog Scale (VAS) for pain, the Disability of the Arm, Shoulder and Hand (DASH) score for functional disability, the Shoulder Pain and Disability Index (SPADI) for pain and disability levels, and the Hospital Anxiety and Depression Scale (HADS) to assess psychological well-being. Results: The results demonstrated significant improvements in all assessment scores. The mean VAS score decreased from 7.6 ± 1.2 at baseline to 3.1 ± 1.0 at 3 months (p < 0.01). The mean DASH score improved from 70.2 ± 12.6 to 35.3 ± 11.8, and SPADI scores dropped from 74.5 ± 13.4 to 39.2 ± 13.2 (both p < 0.01). The HADS scores showed a significant reduction in anxiety and depression symptoms, with the average anxiety score dropping from 10.4 ± 4.1 to 3.2 ± 2.6, and depression scores from 8.3 ± 3.9 to 2.8 ± 2.1 (p < 0.05). The procedure was well tolerated, with no major complications reported. Conclusion: Hydrodilation is a highly effective treatment for frozen shoulder, yielding significant improvements in pain, shoulder function, and psychological well-being. The procedure offers a minimally invasive alternative to surgery with favourable outcomes in reducing both physical disability and psychological distress.