Objective
To investigate whether capsule-preserving hydraulic distension with saline solution and corticosteroid for adhesive capsulitis induces biomechanical alterations in glenohumeral joint capsules along with clinical improvements.
Design
A case series.
Setting
University outpatient clinic of physical medicine and rehabilitation.
Participants
Eighteen patients with unilateral adhesive capsulitis.
Intervention and Main Outcome Measurements
Three hydraulic distensions with saline solution and corticosteroid were performed with 1-month intervals. To avoid rupturing capsules, all distensions were monitored by using real-time pressure–volume curves. Stiffness, maximal volume capacity, and pressure at the maximal volume capacity of the capsule were measured at each intervention. Clinical parameters, such as pain and range of motion, were recorded before, 3 days after, and 1 month after each distension.
Results
Stiffness decreased (47.6 ± 27.1 mm Hg/mL to 31.7 ± 18.4 mm Hg/mL to 24.2 ± 14.0 mm Hg/mL, mean SD) and maximal volume capacity increased (18.8 ± 7.3 mL to 20.5 ± 7.5 mL to 24.2 ± 7.0 mL, mean SD) significantly (
P = .001 for both) at each repeated hydraulic distension. Pressure at the maximal volume capacity tended to decrease, but the decrements were not statistically significant (
P = .662). The clinical parameters were significantly improved throughout and 1 month after the 3 repeat procedures (
P < .05 for all).
Conclusion
Capsule-preserving hydraulic distension changed the biomechanical properties of the glenohumeral joint capsule, lessening the stiffness and enlarging the volume capacity. These alterations were accompanied by improved range of motion and relief of pain. Repeated capsule-preserving hydraulic distension with saline solution and corticosteroid would be useful to treat adhesive capsulitis and to evaluate the treatment results.
