Thompson, Helen, Brealey, Stephen Derek orcid.org/0000-0001-9749-7014, Cook, Liz orcid.org/0000-0001-6902-0235 et al. (3 more authors) (2022) Expert clinical consensus in the delivery of hydrodilatation for the management of patients with a primary frozen shoulder. Bone & Joint Open. pp. 701-709. ISSN 2633-1462
Abstract
Aims To achieve expert clinical consensus in the delivery of hydrodilatation for the treatment of primary frozen shoulder to inform clinical practice and the design of an intervention for evaluation. Methods We conducted a two-stage, electronic questionnaire-based, modified Delphi survey of shoulder experts in the UK NHS. Round one required positive, negative, or neutral ratings about hydrodilatation. In round two, each participant was reminded of their round one responses and the modal (or ‘group’) response from all participants. This allowed participants to modify their responses in round two. We proposed respectively mandating or encouraging elements of hydrodilatation with 100% and 90% positive consensus, and respectively disallowing or discouraging with 90% and 80% negative consensus. Other elements would be optional. Results Between 4 August 2020 and4 August 2021, shoulder experts from 47 hospitals in the UK completed the study. There were 106 participants (consultant upper limb orthopaedic surgeons, n = 50; consultant radiologists, n = 52; consultant physiotherapist, n = 1; extended scope physiotherapists, n = 3) who completed round one, of whom 97 (92%) completed round two. No elements of hydrodilatation were “mandated” (100% positive rating). Elements that were “encouraged” (≥ 80% positive rating) were the use of image guidance, local anaesthetic, normal saline, and steroids to deliver the injection. Injecting according to patient tolerance, physiotherapy, and home exercises were also “encouraged”. No elements were “discouraged” (≥ 80% negative rating) although using hypertonic saline was rated as being “disallowed” (≥ 90% negative rating). Conclusion In the absence of rigorous evidence, our Delphi study allowed us to achieve expert consensus about positive, negative, and neutral ratings of hydrodilatation in the management of frozen shoulder in a hospital setting. This should inform clinical practice and the design of an intervention for evaluation.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2022 Author(s) et al |
Dates: |
|
Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Health Sciences (York) |
Funding Information: | Funder Grant number NETSCC 13/26/01 |
Depositing User: | Pure (York) |
Date Deposited: | 14 Oct 2022 09:20 |
Last Modified: | 02 Dec 2024 01:15 |
Published Version: | https://doi.org/10.1302/2633-1462.39.BJO-2022-0072... |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1302/2633-1462.39.BJO-2022-0072.R1 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:192113 |
Download
Filename: 2633_1462.39.bjo_2022_0072.r1.pdf
Description: Expert clinical consensus in the delivery of hydrodilatation for the management of patients with a primary frozen shoulder
Licence: CC-BY-NC-ND 2.5