An interventional study of Intervention Name: Posterior Intra-articular Injection and Anterior Intra-articular Injection in Adhesive Capsulitis of the Shoulder and Intra Articular Injection, sponsored by Aslinur Keles Ercisli, MD, PhD. Not yet recruiting. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-01-23.
Sponsored by Aslinur Keles Ercisli, MD, PhD · Not applicable, Interventional, and Treatment
This randomized controlled clinical trial aims to compare the efficacy of three different intra-articular injection approaches (anterior, posterior, and combined anterior-posterior) in patients with adhesive capsulitis of the shoulder. Thirty participants will be randomly assigned to one of three groups and treated with a standardized injection solution consisting of corticosteroid, lidocaine, and saline. Clinical outcomes will be evaluated using pain scores, functional scales, and imaging parameters.
Adhesive capsulitis (frozen shoulder) is a disabling condition characterized by progressive pain and stiffness of the glenohumeral joint. Intra-articular corticosteroid injections are frequently used to reduce pain and improve mobility; however, the optimal injection approach remains controversial.
This single-center randomized controlled trial will investigate three different approaches: posterior, anterior, and combined anterior-posterior injections. The primary endpoint is improvement in active and passive range of motion. Secondary endpoints include pain scores (VAS), functional outcome measures (SPADI, qDASH, ASES, Constant-Murley, Scratch Test, Subjective Shoulder Value), and ultrasound evaluation of axillary capsule thickness. Assessments will be performed at baseline, immediately after injection, and at weeks 3, 6, and 12.
Inclusion Criteria Age 18-70 years Unilateral shoulder pain and stiffness (symptom duration 1-9 months) NRS pain score ≥ 7/10 Passive range of motion limitation >50% in at least two planes, or >30° restriction in ≥2 planes "Freezing stage" (stage 2 adhesive capsulitis) No analgesic use (NSAIDs, opioids, acetaminophen) within 12 hours before intervention Radiography and/or MRI excluding other pathologies (rotator cuff tear, labral lesion, osteoarthritis, etc.) Exclusion Criteria Secondary adhesive capsulitis (trauma, surgery, systemic disease) Prior shoulder surgery or intra-articular steroid injection within 3 months Bilateral frozen shoulder Neurological disorders (Parkinson's disease, ALS, neuropathies) Malignancy, infection, cellulitis, septic arthritis, acute fracture Cognitive impairment, psychiatric disorders, pregnancy Steroid or local anesthetic allergy Poor glycemic control or other contraindications to steroid injections
Single intra-articular injection with corticosteroid + lidocaine + saline via the posterior glenohumeral approach.
Drug: Intervention Name: Posterior Intra-articular Injection
Same injection solution administered via the anterior (rotator interval) approach.
Drug: Anterior Intra-articular Injection
Same injection solution administered using both anterior and posterior approaches.
Drug: Combined Anterior + Posterior Intra-articular Injection
A single intra-articular injection consisting of 1 cc corticosteroid, 4 cc 2% lidocaine, and 5 cc saline (total 10 cc) administered via the posterior glenohumeral approach.
Also known as: Posterior Intra-articular Injection
A single intra-articular injection consisting of 1 cc corticosteroid, 4 cc 2% lidocaine, and 5 cc saline (total 10 cc) administered via the anterior (rotator interval) approach.
Also known as: Anterior hydrodilatation
A single intra-articular injection consisting of 1 cc corticosteroid, 4 cc 2% lidocaine, and 5 cc saline (total 10 cc) administered using both anterior and posterior approaches during the same procedure.
Also known as: combined joint injection
Change in Shoulder Range of Motion (ROM)
Change in active and passive shoulder joint range of motion (flexion, extension, abduction, external rotation, internal rotation) measured with a goniometer.
Time frame: Baseline, immediately post-injection, week 3, week 6, week 12
Change in Pain Intensity (NRS)
Number Rating Scale (0-10) for pain at rest, during activity, and at night.
Time frame: Baseline, immediately post-injection, week 3, week 6, week 12
Subjective Shoulder Value (SSV)
Patient's self-reported percentage of normal shoulder function (0-100%).
Time frame: Baseline, immediately post-injection, week 3, week 6, week 12
Shoulder Pain and Disability Index (SPADI)
Questionnaire assessing pain and disability (0-100 score, higher scores = worse function).
Time frame: Baseline, week 3, week 6, week 12
Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH)
Questionnaire measuring upper limb disability and symptoms (0-100 score, higher = worse).
Time frame: Baseline, week 3, week 6, week 12
American Shoulder and Elbow Surgeons (ASES) Score
Composite score including pain and function (0-100, higher = better).
Time frame: Baseline, week 3, week 6, week 12
Constant-Murley Shoulder Score
Clinical score combining pain, activities of daily living, strength, and ROM (0-100).
Time frame: Baseline, week 3, week 6, week 12
Scratch Test Score
Functional test measuring the patient's ability to reach behind the back.
Time frame: Baseline, immediately post-injection, week 3, week 6, week 12
Axillary Capsule Thickness (Ultrasound)
Ultrasound measurement of axillary recess capsule thickness on the affected shoulder.
Time frame: Baseline, immediately post-injection (only).
No study locations are listed for this record.
Plan to share: No
No publications or documents are linked to this record.
This study is not yet recruiting, as verified in Jan 2026. You cannot join it, but the record below documents what was studied.
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Aslinur Keles Ercisli, MD, PhD