Expert clinical consensus in the delivery of hydrodilatation for the management of patients with a primary frozen shoulder

Journal article

Introduction: Frozen shoulder is a disabling condition characterised by severe pain and loss of shoulder movement. Corticosteroid injections are targeted at reducing pain in the earlier painful phase. There are multiple studies on the effectiveness of injections for frozen shoulder, but none were identified to assess if this guidance has been translated into clinical practice. The aim of this survey was to investigate the current practice and opinion of musculoskeletal health professionals regarding corticosteroid injections for frozen shoulder. Design and Methods: The online survey was disseminated via the social media platform ‘X’ (at the time of the survey known as Twitter) over a 5-week period. Recruitment was by the ‘snowball’ effect. Responses to multiple choice survey questions were analysed with descriptive data. Free text questions were analysed using content analysis. Results: The number of respondents to the survey was 235. Respondents felt injections have an important role in the management of frozen shoulder (155/235, 66%) and the best time to inject is during the pain predominant phase (191/233; 82%). The glenohumeral joint was the preferred anatomical site to inject (136/235; 58%) with triamcinolone as the preferred steroid (66/155; 43%). A steroid dose of 40 mg/mL was favoured by 55% (83/151) of respondents. Conclusion: Corticosteroid injections play an important role in the management of frozen shoulder. There was consensus for the type and dose of corticosteroid and anaesthetic; however, the range of preparations used indicated that many decisions may be based on personal preference or local guidelines

Authors: Thompson, H; Brealey, S; Cook, E; Hadi, S; Khan, SHM

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: British Editorial Society of Bone and Joint Surgery
• Journal: Bone & Joint Open
• Volume: 3
• Issue: 9
• Pages: 701-709
• Publication date: 2022-09-05
• DOI: 10.1302/2633-1462.39.bjo-2022-0072.r1
• EISSN: 2633-1462
• ISSN: 2633-1462
• Language: English
• Keywords: Hypertonic saline; Scope (computer science); Delphi; Nominal group; Intervention (counseling); Medicine; Physical therapy; Delphi method; Nursing