injuryupdate
10-12-2004, 08:14 PM
I heard recently that at Victoria House Radiology in Melbourne, over the last two decades, they have performed over 50,000 hydrodilatation procedures. I'm not sure how accurate this figure is - it averages out to about 8 per day if the suggested figure is accurate.
The primary indication for this is to increase shoulder range of motion, particularly in adhesive capsulitis (frozen shoulder). Cortisone is used as part of the procedure, and there is some evidence that cortisone injections are helpful in shoulder pain.
However, hydrodilatation is hardly even available in Sydney.
There is very little evidence to support its efficacy. Admittedly there are many procedures where we do not have great evidence to support use, and for example, there would have been many more knee arthroscopic chondroplasties performed for osteoarthritis over this time. The latest evidence for this procedure suggests it does no better than placebo.
Hydros simply haven't been studied. We don't have great evidence to suggest that they work or they don't.
The theory is good - increasing ROM.
It is interesting that Medicare will fund people to have these procedures without demanding an RCT, but they won't fund other treatments that have been proven to work (such as physio for anterior knee pain).
Also, if hydros actually work, we should know about it, as people in other states of Australia are missing out if it is successful.
The primary indication for this is to increase shoulder range of motion, particularly in adhesive capsulitis (frozen shoulder). Cortisone is used as part of the procedure, and there is some evidence that cortisone injections are helpful in shoulder pain.
However, hydrodilatation is hardly even available in Sydney.
There is very little evidence to support its efficacy. Admittedly there are many procedures where we do not have great evidence to support use, and for example, there would have been many more knee arthroscopic chondroplasties performed for osteoarthritis over this time. The latest evidence for this procedure suggests it does no better than placebo.
Hydros simply haven't been studied. We don't have great evidence to suggest that they work or they don't.
The theory is good - increasing ROM.
It is interesting that Medicare will fund people to have these procedures without demanding an RCT, but they won't fund other treatments that have been proven to work (such as physio for anterior knee pain).
Also, if hydros actually work, we should know about it, as people in other states of Australia are missing out if it is successful.