J Korean Orthop Assoc.  2023 Jun;58(3):227-237. 10.4055/jkoa.2023.58.3.227.

Effects of Intra-Articular Corticosteroid Injection Treatment According to Whether Hydrodilatation in Idiopathic Hip Joint Adhesive Capsulitis: A Retrospective Comparative Study

• Chung W
• Cho HM
• Ham DH
• Seo J

• KMID: 2543270
• DOI: http://doi.org/10.4055/jkoa.2023.58.3.227

Abstract

Purpose
Adhesive capsulitis of the hip is a painful condition that causes a restriction of motion but can be managed with various conservative treatments. This retrospective study compared the results of the palliative intra-articular injection of steroids and intraarticular injection with hydraulic distension in patients with adhesive capsulitis of the hip joint.
Materials and Methods
Patients who underwent palliative intra-articular injection of steroids (Group A, 50 cases) or who received hydraulic distension (Group B, 48 cases) in the authors’ center from January 2017 to December 2021 were enrolled in this study. The hip pain (visual analog scale [VAS] score), function evaluation (Harris hip score, The Western Ontario and McMaster Universities Arthritis Index [WOMAC] score), and range of motion (flexion abduction, internal rotation, and distance between the knee joint and the floor) were compared and analyzed at 6, 12, and 24-week intervals after treatment. Patients who received a second injection because of a lack of improvement after three months were recorded, and complications related to the injection during the follow-up period were investigated.
Results
The VAS score immediately after the injection was significantly greater in the case of hydrostatic distension. On the other hand, from 6 to 24 weeks after injection, there was a significant improvement in the VAS scores compared to before injection, and there was no significant difference between the VAS scores in Groups A and B. From 6 to 24 weeks after injection, the Harris hip score, WOMAC score, and range of motion of the hip joint (flexion, abduction, internal rotation, external rotation, and distance between the knee joint and the floor) showed significant improvement compared to that before injection, but with no significant difference between the groups. Re-injection was performed in four and five cases (p=0.679) in Groups A and B, respectively. One patient in Group B, who had hydrostatic distension, complained of severe pain immediately after injection and was hospitalized (p=0.305).
Conclusion
In patients with idiopathic adhesive capsulitis of the hip, intra-articular steroid injection resulted in significant symptom improvement regardless of the hydraulic distension, with no differences between the methods. On the other hand, the combination of hydraulic distension can cause relatively severe pain immediately after injection, meaning that an appropriate explanation before and after injection is necessary.

Keyword

adhesive capsulitis; hip; capsule; intra-articular injection; hydrodilatation