Adhesive Capsulitis Embolization Compared to Traditional Options

Our previous blog delved into frozen shoulder and the innovative adhesive capsulitis embolization (ACE) procedure. Now, let’s take a broader look at ACE and compare it to traditional treatments for frozen shoulder or adhesive capsulitis. Exploring the full range of options empowers patients and healthcare providers to make well-informed decisions about the best path to recovery.

Overview of Treatment Options

Before we dive into comparisons, here are the primary treatment options for adhesive capsulitis:

1. Conservative Management
   1. Physical therapy
   2. NSAIDs and pain medications
   3. Corticosteroid injections
2. Minimally Invasive Procedures
   1. Hydrodilatation
   2. Adhesive capsulitis embolization (ACE)
3. Surgical Interventions
   1. Manipulation under anesthesia
   2. Arthroscopic capsular release

Now, let’s examine how ACE compares to each of these approaches.

ACE vs. Conservative Management

Conservative management is typically the first-line treatment for adhesive capsulitis. Here’s how ACE compares:

Effectiveness

• Conservative management: This can be effective but often requires several months of treatment. Success rates vary widely, with some studies reporting improvement in 50-90% of patients within 2-3 years.
• ACE: Studies have shown significant pain reduction and improved function in 67-87% of patients within 6 months.

Invasiveness

• Conservative management: Non-invasive but may require multiple therapy sessions and injections.
• ACE: Minimally invasive, typically performed as a single outpatient procedure.

Recovery Time

• Conservative management: Gradual improvement over months to years.
• ACE: Many patients report improvements within weeks, with continued progress over several months.

Considerations

• Conservative management is generally recommended as the initial approach due to its non-invasive nature.
• ACE may be considered when conservative management fails to provide adequate relief after several months.

ACE vs. Hydrodilatation

Hydrodilatation, or arthrographic distension, involves injecting saline and corticosteroids into the joint capsule to stretch it.

Effectiveness

• Hydrodilatation: Studies show varying degrees of effectiveness, with some reporting significant improvements in 50-80% of patients.
• ACE: Recent studies indicate success rates of 67-87% in terms of pain reduction and functional improvement.

Invasiveness

• Both procedures are minimally invasive and typically performed on an outpatient basis.

Recovery Time

• Hydrodilatation: Patients may experience immediate relief but often require multiple sessions for optimal results.
• ACE: Many patients report improvements within weeks after a single procedure.

Considerations

• Hydrodilatation directly addresses capsular tightness, while ACE targets abnormal blood vessels associated with inflammation.
• The choice between these procedures may depend on the specific characteristics of the patient’s condition and local expertise.

ACE vs. Surgical Intervention

Surgical interventions are typically considered when conservative treatments have failed to provide adequate relief.

Effectiveness

• Surgical intervention: Can be highly effective, with success rates of 70-90% reported in various studies.
• ACE: Recent studies show comparable success rates of 67-87%, although long-term comparative data are limited.

Invasiveness

• Surgical intervention: More invasive, requiring general anesthesia and involving manipulation or incisions.
• ACE: Minimally invasive, performed under local anesthesia or mild sedation.

Recovery Time

• Surgical intervention: This may require several weeks to months of rehabilitation.
• ACE: Many patients report improvements within weeks, with a faster return to normal activities.

Considerations

• Surgical intervention carries higher risks of complications but may be necessary in severe or refractory cases.
• ACE offers a less invasive alternative that may be suitable for patients who are not candidates for surgery or prefer to avoid it.

Factors to Consider When Choosing a Treatment

When deciding between ACE and other treatment options, consider the following factors:

1. Duration and severity of symptoms
2. Response to previous treatments
3. Overall health and ability to undergo various procedures
4. Personal preferences and risk tolerance
5. Availability of experienced providers for each treatment option
6. Cost and insurance coverage

Adhesive capsulitis embolization (ACE) is a promising addition to the treatment options for frozen shoulder. It shows comparable or potentially superior results to some traditional treatments regarding effectiveness and recovery time. However, it’s important to note that ACE is still a relatively new procedure with limited long-term data.

The choice of treatment should be made individually, considering the specific characteristics of the patient’s condition, overall health, and personal preferences. As always, it’s crucial to consult with healthcare providers who can offer expertise on the full range of treatment options and help determine the most appropriate approach for each unique case. Please schedule an appointment or contact us today to discuss your treatment options for frozen shoulder.