Intra-articular injection, subacromial injection, and hydrodilatation for primary frozen shoulder: a randomized clinical trial

J Shoulder Elbow Surg. 2016 Mar;25(3):376-83. doi: 10.1016/j.jse.2015.11.009.


Background: The aim of this prospective randomized study was to compare the efficacy of 3 injection methods, intra-articular injection, subacromial injection, and hydrodilatation (HD), in the treatment of primary frozen shoulder.

Methods: Patients with primary frozen shoulder were randomized to undergo intra-articular injection (n = 29), subacromial injection (n = 29), or HD (n = 28). Evaluations using a visual analog scale for pain, Simple Shoulder Test, Constant score, and passive range of shoulder motion were completed before treatment and 1 month, 3 months, and 6 months after treatment.

Results: Among the 3 injection methods for primary frozen shoulder, HD resulted in a greater range of motion in forward flexion and external rotation, a lower visual analog scale score for pain after 1 month, and better outcomes for all functional scores after 1 month and 3 months of follow-up. However, there were no significant differences in any clinical outcomes among the 3 groups in the final follow-up at 6 months.

Conclusions: Although HD yielded more rapid improvement, the 3 injection methods for primary frozen shoulder resulted in similar clinical improvement in the final follow-up at 6 months.

Keywords: Primary frozen shoulder; hydrodilatation; injection method; intra-articular injection; stiff shoulder; subacromial injection.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acromion
  • Bursitis / physiopathology
  • Bursitis / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Intra-Articular / methods
  • Male
  • Middle Aged
  • Prospective Studies
  • Range of Motion, Articular
  • Shoulder Joint
  • Sodium Chloride / administration & dosage*
  • Triamcinolone / administration & dosage*


  • Triamcinolone
  • Sodium Chloride