Arthrodilation: a treatment algorithm as a conservative management option for adhesive capsulitis.

Introduction: the management of adhesive capsulitis (AC) remains a topic of debate among orthopedic surgeons, with a wide variation in the literature. Conservative treatment relies as the first-line option as clinical studies report positive outcomes. However, there is variability in the effectiveness of different treatment modalities.

Material and methods: this study aimed to analyzed functional and clinical outcomes of patients with AC who underwent the arthrodilation protocol, including three ultrasound-guided injections administered on a weekly basis: two corticosteroid injections and one injection of hyaluronic acid combined with corticosteroids. Additionally, patients received a specific rehabilitation therapy. Visual analogue scale (VAS), the university of California-Los Angeles shoulder score (UCLA) and Constant-Murley score were assessed before treatment and after 3-month follow-up period.

Results: 23 patients were included, receiving the same treatment protocol with a mean onset of symptoms of 4.9 ± 1.7 months. Among these patients, there was a clear predominance of females (65.2%). Age distribution ranged from 39 to 74 years (mean = 56) indicating that individuals in their mid-50s were more susceptible to developing this condition. Furthermore, a slight majority (52.2%) exhibited AC in their right shoulder. VAS significantly decreased (-6.09 ± 1.9 [p 0.05]). Similarly, UCLA score (10.9 ± 2.9 to 31.7 ± 2.2) and Constant-Murley score (22.3 ± 6.1 to 62.0 ± 6.2) improved significantly. Pre-to-post treatment evaluation showed improvement in both UCLA (mean = 20.8 ± 2.9 [p 0.05]) and Constant-Murley (mean = 39.7 ± 9 [p 0.05]).

Conclusion: arthrodilation protocol demonstrated promising results, with patients achieving good to excellent outcomes and safely resuming their regular daily activities within a short-term follow-up period. These findings provide support for arthrodilation as a viable conservative management option and contribute valuable insights to the ongoing research aimed at identifying optimal treatment approaches for adhesive capsulitis.