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Rate ePoster

Musculoskeletal and Sports Medicine

Hydrodilatation versus Corticosteroid Injection for Adhesive Capsulitis: A Systematic Review and Meta-Analysis

Thursday, October 23, 2025
12:45 PM - 2:15 PM MT
Location: Kiosk 7

    Poster Presenter(s)

  • Grace Olson, Other

    Medical Student
    Boston University Chobanian & Avedisian School of Medicine
    Roxbury, Massachusetts

    • Co-Author(s)

  • Jaehyung Shin, BS

    Undergraduate Student (Graduated)
    Georgia Institute of Technology
    Corona, California

  • Rachel Fetterman, MA (she/her/hers)

    Medical Student
    University of Massachusetts Medical School
    Worcester, Massachusetts

  • Raymond Guo, MD

    Resident Physician
    MassGeneral Brigham/Spaulding Rehabilitation/Harvard Medical School PM&R Program
    Plano, Texas

  • Dylan B. Combs, MD

    Resident Physician
    MassGeneral Brigham/Spaulding Rehabilitation/Harvard Medical School PM&R Program
    Charlestown, Massachusetts

  • XP

    Xiaoyu Pan, MD,MPH

    Resident physician
    University of Texas Southwestern Medical Center
    Framingham, Massachusetts

  • JR

    Joseph Ruiz, MD

    Resident Physician
    MassGeneral Brigham/Spaulding Rehabilitation/Harvard Medical School PM&R Program
    Somerville, Massachusetts

  • KM

    Katelyn McCarron, Other

    Researcher
    Mass General Brigham
    Carver, Massachusetts

  • HR

    Hye Chang Rhim, MD

    Sports Medicine Fellow
    Spaulding Rehabilitation Hospital/Harvard Medical School PM&R Program
    Charlestown, Massachusetts

Disclosure(s):
Grace Olson, Other: No financial relationships to disclose
Jaehyung Shin, BS: No financial relationships to disclose
Rachel Fetterman, MA: No financial relationships to disclose
Raymond Guo, MD: No financial relationships to disclose
Dylan B. Combs, MD: No financial relationships to disclose
Joseph Ruiz, MD: No financial relationships to disclose
Background and/or Objectives: The aim was to compare the efficacy of hydrodilatation and corticosteroid injection (CSI) alone in patients with adhesive capsulitis at 12 weeks.

Design: Systematic review with meta-analysis

Setting : Outpatient

Participants : 991 patients with adhesive capsulitis

Interventions: Hydrodilatation versus CSI

Main Outcome Measures: Standardized mean differences (SMD) of visual analogue scale (VAS), shoulder pain and disability index (SPADI), and ROM (abduction, external rotation, and flexion) calculated through random-effects meta-analyses.

Results: After screening 679 studies from PubMed, Embase, and Web of Science databases 16 randomized control trials (10 high risk of bias and 6 some concerns) were included. Compared to CSI, hydrodilatation was associated with significantly greater external rotation (6 RCTs, SMD 0.61, 95% CI 0.14 to 1.08) at 12 weeks. However, there were no significant differences in VAS scores (8 RCTs, SMD -0.21, 95% CI -0.93 to 0.50), SPADI scores (8 RCTs, SMD -0.26, 95% CI -0.71 to 0.19), abduction (5 RCTs, SMD 0.37, 95% CI -0.19 to 0.93), and forward flexion (6 RCTs, SMD 0.31, 95% CI -0.10 to 0.72). Subgroup analyses revealed that hydrodilatation volumes >20 mL were associated with better pain scores (5 RCTs, SMD 0.60, 95% CI 0.16 to 1.04) while volumes ≤20 mL were associated with worse pain scores (3 RCTs, SMD -2.64, -4.72 to -0.56) and SPADI scores than CSI alone (5 RCTs, SMD -0.54, 95% CI -1.07 to -0.02).

Conclusions: Hydrodilatation may offer greater improvements in external rotation at 12 weeks without significant differences in pain or functional ability when compared to CSI. Hydrodilatation volume greater than 20 mL may provide additional benefits in pain and functional ability, while low injection volumes may not necessarily lead to better outcomes than CSI.