Title: Comparative study of intraarticular steroid injection and normal saline for the treatment of Idiopathic frozen shoulder

Authors: Prof. Bashir Ahmed Mir, Dr Hilal Ahmad Kotwal, Dr Mohd Iqbal Wani

 DOI: https://dx.doi.org/10.18535/jmscr/v8i9.37

Abstract

Idiopathic frozen shoulder is amongst the common problems in orthopedic outpatient department which is characterized by gradual and progressive pain and stiffness of the shoulder joint followed by loss of motion and finally spontaneous recovery over the period of time. Different modalities of treatment are available for Idiopathic frozen shoulder, but none has got universal acceptability. The purpose of this study was to compare the outcome of   intra-articular steroid injection and normal saline.

Methods: This was a comparative study done at Government bone and joint surgery hospital Barzulla Srinagar between April 2019 to April 2020, which included 60 patients with Idiopathic Frozen shoulder. There were 30 patients in each group. The mean age of respondent was 57.36 years. Simple Random method of sampling was adopted for selecting patients for each group. Hydroplasty group was given 30ml normal saline 4 ml 2% Lidocain (plain) and 4 ml 0.5% Bupivacain (total volume:40ml) and steroid group was given 2ml Methylprednisolone, 4ml 2% Lidocain(pain), 4ml 0.5% Bupivacain with total volume: 10 ml. Both groups were attached for therapeutic exercises. Comparison of outcomes between two treatment groups was done using Visual Analogue Scale (VAS) for pain, Shoulder Pain and Disability Index for Shoulder function and degree of range of motion.

Statistical analysis was done using SPSS 17.0

Results: There was significant improvement in level of pain, Shoulder function (Shoulder Pain and Disability Index) and range of motion in forward flexion, abduction, external rotation, and internal rotation in four month period in Steroid group compared to normal saline group.

Conclusion: There was a significant improvement in pain, range of movement and Shoulder Pain and Disability Index (SPADI) score in all patients of both group but the difference in improvement was found to be statistically significant in steroid injection group, So steroid injection was found to be more effective treatment modality than normal saline in idiopathic frozen shoulder in short term follow up.

Keywords: Frozen shoulder, Hydroplasty, Intrarticular steroid injection, Shoulder pain and Disability Index.

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