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Effects of intra-articular steroid injection before pan-capsular release in patients with refractory frozen shoulder

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Abstract

Purpose

The purpose of the study was to retrospectively determine the effects of intra-articular steroid injection on the clinical outcome of patients who underwent arthroscopic pan-capsular release for refractory frozen shoulder.

Methods

Between 2000 and 2010, 34 patients (20 males, 14 females) who underwent an arthroscopic pan-capsular release for frozen shoulder were included. Intra-articular steroid injections were administered from April 2006, and just before surgery and at the final follow-up, ranges of motion (ROM) and scores of the Shoulder Rating Scale of the University of California, Los Angeles (UCLA) scoring system were evaluated.

Results

Intra-articular steroid injection significantly improved the UCLA scores of pain just before surgery and at the final follow-up (1.7 ± 0.5 vs. 6 ± 2, p < 0.0001). We subdivided the patients into those with and without diabetes mellitus. Steroid injection had a significant effect on the ROM in forward flexion (166.6 ± 8.6 vs. 140 ± 36.1, p = 0.026) and the scores of pain (10 vs. 9.3 ± 1.2, p = 0.046) at the final follow-up in the group without diabetes mellitus compared with those with it.

Conclusion

Intra-articular steroid injection improves pain just before an arthroscopic pan-capsular release and at the final follow-up in all the patients with refractory frozen shoulder. However, it improves the ROM in forward flexion and the UCLA scores of pain at the final follow-up only in those without diabetes mellitus.

Level of evidence

Therapeutic studies, Level IV.

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Correspondence to Yoshihiro Hagiwara.

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Hagiwara, Y., Sugaya, H., Takahashi, N. et al. Effects of intra-articular steroid injection before pan-capsular release in patients with refractory frozen shoulder. Knee Surg Sports Traumatol Arthrosc 23, 1536–1541 (2015). https://doi.org/10.1007/s00167-014-2936-2

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Keywords

  • Intra-articular steroid injection
  • Frozen shoulder
  • Adhesive capsulitis
  • Pan-capsular release