Hyhydrodilatation (distension arthrography); a long term clinical outcome series

Abstract

Objectives This longitudinal study describes and compares the medium to long-term effectiveness of Hydrodilatation (HD) and post-HD physiotherapy in patients with primary and secondary glenohumeral joint contracture associated with rotator cuff pathology.

Methods Patients with primary and secondary glenohumeral contractures associated with rotator cuff pathology were recruited into a 2 year study. They all underwent hydrodilatation (HD) followed by a structured physiotherapy programme. Patients were assessed at baseline, three days, one week, three months, one year and two years post HD with primary outcome measures (Shoulder Pain and Disability Index, Shoulder Disability Index, Percentage rating of "normal" function) and secondary outcome measures (range of shoulder abduction, external rotation, hand behind back). Comparisons in recovery were made between the primary and secondary glenohumeral contracture groups at all timeframes and for all outcome measures.

Results Fifty-three patients (23 with primary and 30 with secondary glenohumeral contractures) were recruited into the study. At the 2 year follow-up, 12 patients dropped out from the study. At baseline, the two contracture groups were similar with respect to their demographic and physical characteristics. The two groups of patients recovered in a similar fashion over the 2 year follow-up period. There was a statistically significant increase in all outcome measures over this time (p<0.01), so that both function and range of movement increased. The rate of improvement was dependent on the outcome measure that was used.

Conclusions The results of this study demonstrate that HD and physiotherapy increase shoulder motion in individuals with primary and secondary glenohumeral joint contracture associated with rotator cuff pathology. This benefit continues to improve or is maintained in the long term: up to two years post-HD.