Hydrodilatation Effective for Adhesive Capsulitis Despite Rotator Cuff Tears: Study

Written By : Dr Supreeth D R Published On 2026-01-19T20:00:37+05:30 | Updated On 20 Jan 2026 1:02 PM IST

Adhesive capsulitis (AC) is a chronic, debilitating condition characterized by pain and progressive stiffness of the shoulder joint. Hydrodilatation (HD) is a commonly used method of non-surgical management. However, its effectiveness in patients with rotator cuff pathology remains unclear.

Aishwarya Prakash et al conducted a study to evaluate and compare the clinical effectiveness of HD in patients with AC, with and without rotator cuff tears. A secondary objective was to assess clinical outcomes in patients with concurrent type 2 diabetes mellitus.

The retrospective cohort comprised 78 patients (six excluded due to loss to follow-up and two excluded due to incomplete data) who underwent HD. Patients were stratified by rotator cuff integrity (intact n=60, partial-thickness tear n=10, full-thickness tear n=8). Pain (Visual Analog Scale (VAS)) and range of motion (ROM: abduction, flexion, and external rotation) were recorded at baseline, six weeks, three months, and six months. Change scores were analyzed using the Wilcoxon signed-rank and Kruskal- Wallis tests with Benjamini-Hochberg false discovery rate (FDR) correction. The primary endpoint was the change in abduction at three months.

The key findings of the study were:

• All groups demonstrated significant within-group improvements in pain and ROM (all p-values adjusted for multiple comparisons using the Benjamini-Hochberg FDR (p(FDR < 0.05), except flexion at six months in the full-thickness tear group (p(FDR) = 0.271).

• At three months, median abduction improvement was 80° (60-90) in the intact group vs 40° (20-75) in partial-thickness and 35° (17.5-70) in full-thickness tears (H=13.21, p(FDR)=0.005).

• External rotation gains were also greater in the intact group, most notably at three months (Z=3.91, p(FDR) = 0.002 vs partial-thickness).

• Pain reduction was observed in all groups, but reductions were greater in the intact versus full-thickness subgroup (three months: Z=−3.08, p(FDR)=0.014).

• Patients with diabetes demonstrated attenuated ROM recovery but similar pain improvement compared with nondiabetic patients.

The authors concluded – “HD provided meaningful pain relief across all patient subgroups in this retrospective cohort. However, rotator cuff integrity substantially influenced ROM recovery, with reduced gains in patients with partial and full-thickness tears. Diabetic patients appeared to achieve less ROM improvement, although this subgroup was small, and findings should be interpreted cautiously. Pre-procedure imaging and individualised counselling are recommended.”

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.