To explore the clinical efficacy and safety of shoulder joint injection lysis combined with joint capsule hydrodistention and manipulation loosening in the treatment of patients with intractable frozen shoulder.

Sixty-six patients with intractable frozen shoulder in Department of Anesthesiology and Pain Medicine, Tenth People's Hospital of Tongji University, from May 2018 to May 2021 were prospectively analyzed and divided by random number table method into two groups. The patients were treated with ultrasound-guided adhesion lysis in the routine treatment group (n=34), while with ultrasound-guided shoulder joint injection lysis combined with joint capsule hydrodistention and manipulation loosening in the combined treatment group (n=32). All patients were treated once a week for 3 times in both groups. Visual analogue scale (VAS) in resting and moving, Constant-Murley score (CMS) of shoulder joint, curative effect and adverse reactions were recorded before the treatment, and 1 month, 3 months and 6 months after the treatment.

No serious adverse reactions were found. Compared with pre-treatment, VAS in moving were significantly lower in the two groups at 1 month, 3 months and 6 months after the treatment (all P<0.05). Compared with VAS in moving were (2.5±0.8, 2.6±0.9, 2.8±0.9) score in routine treatment group, and were (1.0±0.8, 1.4±0.5, 1.9±0.6) score in the combined treatment group at 1 month, 3 months and 6 months after the treatment (all P<0.05). VAS in resting decreased significantly after the treatment at 1 month, 3 months and 6 months in the two groups (all P<0.05). There was no statistical significance between the two groups at each time point (all P>0.05). Compared with pre-treatment, the CMS of shoulder joints increased significantly in the two groups at 1 month, 3 months and 6 months after the treatment (all P<0.05). And CMS in the combined group were (91.1±2.5, 85.9±4.5, 84.5±5.1) score, shown better than the routine treatment group (80.4±6.6, 75.6±5.6, 74.6±4.3) score (all P<0.05). The excellent and good rate (100.0%, 100.0%, 96.9%) in the combined treatment group at 1 month, 3 months and 6 months was higher than those in the routine treatment group (76.5%, 64.7%, 61.8%).

Ultrasound-guided injection lysis combined with joint capsule hydrodistension and manipulation loosening can significantly reduce the pain and improve shoulder function safely in patients with intractable frozen shoulder.

Frozen shoulder; Ultrasound-guided; Hydrodistension (hydraulic distension); Manipulation; Brachial plexus block