Comparison of Ultrasound-Guided Subacromial vs. Systemic Steroid Injections for Frozen Shoulder: a Multicenter Pilot Study

NCT ID: NCT06626568

Last Updated: 2025-11-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-15

Study Completion Date

2025-09-02

Brief Summary

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The goal of this multicenter pilot study is to validate the effectiveness of extending the injection interval between betamethasone doses from one to two weeks for treating frozen shoulder (adhesive capsulitis) in adults aged 18 to 75. This study also aims to screen potential study centers and gather data to refine the sample size calculation for a larger, future trial. The main questions it aims to answer are:

* Does extending the interval between injections maintain effectiveness in improving shoulder function and reducing pain for frozen shoulder?
* Which centers in this pilot study are qualified for a larger, future trial?
* What is the appropriate sample size for conducting a multicenter RCT study with the same research design at the selected centers?

Participants will:

* Receive 3 injections over 4 weeks and will be followed up for another 8 weeks
* Complete shoulder function assessments
* Perform home rehabilitation exercises

Detailed Description

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Conditions

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Frozen Shoulder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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gluteal injection

gluteal injection of 1 ml of Compound betamethasone and 4 ml of normal saline at week 0,2,4, ultrasound-guided subacromial injection of 5 ml of normal saline at week 0,2,4.

The participants were instructed to perform home rehabilitation exercise for 12 weeks. 30 minutes of home-based self-rehabilitation exercises in the morning, afternoon, and evening, with a total of 90 minutes per day. Standard instructional videos and demonstrations by outpatient rehabilitation therapists are provided to participants. Each exercise, including wall-climbing, table-climbing, and back-climbing, should be performed for 10 minutes, with a total of 30 minutes per session.

Group Type EXPERIMENTAL

Compound betamethasone Injection(Gluteal muscle injection)

Intervention Type DRUG

gluteal injection of 1 ml of Compound betamethasone and 4 ml of normal saline at week 0,2,4

Normal Saline as Placebo (ultrasound-guided subacromial injection)

Intervention Type OTHER

ultrasound-guided subacromial injection of 5 ml of normal saline at week 0,2,4.

home exercise

Intervention Type BEHAVIORAL

The participants were instructed to perform home rehabilitation exercise for 12 weeks. 30 minutes of home-based self-rehabilitation exercises in the morning, afternoon, and evening, with a total of 90 minutes per day. Standard instructional videos and demonstrations by outpatient rehabilitation therapists are provided to participants. Each exercise, including wall-climbing, table-climbing, and back-climbing, should be performed for 10 minutes, with a total of 30 minutes per session.

subacromial injection

gluteal injection of 5 ml normal saline at week 0,2,4, ultrasound-guided subacromial injection of 1 ml of Compound betamethasone and 4 ml of normal saline at week 0,2,4.

The participants were instructed to perform home rehabilitation exercise for 12 weeks. 30 minutes of home-based self-rehabilitation exercises in the morning, afternoon, and evening, with a total of 90 minutes per day. Standard instructional videos and demonstrations by outpatient rehabilitation therapists are provided to participants. Each exercise, including wall-climbing, table-climbing, and back-climbing, should be performed for 10 minutes, with a total of 30 minutes per session.

Group Type ACTIVE_COMPARATOR

Compound betamethasone Injection(Subacromial Ultrasound Guided injection)

Intervention Type DRUG

ultrasound-guided subacromial injection of 1 ml of Compound betamethasone and 4 ml of normal saline at week 0,2,4.

Normal Saline as Placebo (gluteal muscle inection)

Intervention Type OTHER

gluteal injection of 5 ml normal saline at week 0,2,4.

home exercise

Intervention Type BEHAVIORAL

The participants were instructed to perform home rehabilitation exercise for 12 weeks. 30 minutes of home-based self-rehabilitation exercises in the morning, afternoon, and evening, with a total of 90 minutes per day. Standard instructional videos and demonstrations by outpatient rehabilitation therapists are provided to participants. Each exercise, including wall-climbing, table-climbing, and back-climbing, should be performed for 10 minutes, with a total of 30 minutes per session.

Interventions

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Compound betamethasone Injection(Gluteal muscle injection)

gluteal injection of 1 ml of Compound betamethasone and 4 ml of normal saline at week 0,2,4

Intervention Type DRUG

Compound betamethasone Injection(Subacromial Ultrasound Guided injection)

ultrasound-guided subacromial injection of 1 ml of Compound betamethasone and 4 ml of normal saline at week 0,2,4.

Intervention Type DRUG

Normal Saline as Placebo (ultrasound-guided subacromial injection)

ultrasound-guided subacromial injection of 5 ml of normal saline at week 0,2,4.

Intervention Type OTHER

Normal Saline as Placebo (gluteal muscle inection)

gluteal injection of 5 ml normal saline at week 0,2,4.

Intervention Type OTHER

home exercise

The participants were instructed to perform home rehabilitation exercise for 12 weeks. 30 minutes of home-based self-rehabilitation exercises in the morning, afternoon, and evening, with a total of 90 minutes per day. Standard instructional videos and demonstrations by outpatient rehabilitation therapists are provided to participants. Each exercise, including wall-climbing, table-climbing, and back-climbing, should be performed for 10 minutes, with a total of 30 minutes per session.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

1. History of ≤9 months, clinically diagnosed with primary frozen shoulder (including frozen shoulder associated with diabetes).
2. Aged between 18 and 75 years old
3. Pain NRS score ≥4
4. Measured passive range of motion of the affected shoulder in at least two of the three directions (forward flexion, external rotation with arm at the side, and internal rotation with arm at the side) is reduced by 25% or more compared to the contralateral normal shoulder.
5. Exclusion of osteoarthritis, dislocation, and other shoulder abnormalities through X-ray and MRI of the affected shoulder.

Exclusion Criteria

1. Secondary frozen shoulder caused by thyroid disease, cardiovascular disease, cancer, stroke, radiotherapy, neurosurgery, or breast surgery (excluding diabetes); secondary frozen shoulder caused by major shoulder trauma requiring medical care (e.g., fractures, dislocations, rotator cuff tears).
2. Full-thickness rotator cuff tear in the affected shoulder confirmed by MRI (excluding rotator cuff tendinopathy and partial-thickness rotator cuff tear in patients with frozen shoulder without a history of major shoulder trauma).
3. Patients unable to undergo MRI due to financial reasons, claustrophobia, pacemaker, or other metallic implants in the body.
4. Local infection in the affected shoulder or other contraindications to shoulder injections.
5. Patients with contraindications to steroid therapy (e.g., poorly controlled blood sugar in diabetes).
6. Patients with frozen shoulder who have already undergone shoulder injections, manipulation under anesthesia, arthroscopic capsular release, or open surgery for capsular release.
7. Received any form of steroid treatment within the past 3 months.
8. History of glucocorticoid use for more than 3 months.
9. Bilateral frozen shoulder or a history of frozen shoulder in the contralateral shoulder.
10. Pregnant or breastfeeding women.
11. Patients lacking the cognitive ability to comply with the study protocol.
12. Patients not residing in the area where the study is being conducted.
13. Patients with compensation claims or legal disputes related to workplace injury or car accidents.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Second Affiliated Hospital, School of Medicine, Zhejiang University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Bin Han, Medical Doctor

Role: PRINCIPAL_INVESTIGATOR

The 2nd Affiliated Hospital of Zhejiang University

Locations

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Guangde County People's Hospital

Xuancheng, Anhui, China

Site Status

Army Specialty Medical Center of the People's Liberation Army of China

Chongqing, Chongqing Municipality, China

Site Status

The Second Affiliated Hospital, Fujian Medical University

Quanzhou, Fujian, China

Site Status

Yangpu District Central Hospital of Shanghai

Shanghai, Shanghai Municipality, China

Site Status

The Third Affiliated Hospital of Zhejiang Chinese Medical University

Hangzhou, Zhejiang, China

Site Status

Second Affiliated Hospital, School of Medicine, Zhejiang University

Hangzhou, Zhejiang, China

Site Status

The First People's Hospital of Linping District, Hangzhou

Hangzhou, Zhejiang, China

Site Status

Huzhou Central Hospital

Huzhou, Zhejiang, China

Site Status

Pujiang People's Hospital

Jinhua, Zhejiang, China

Site Status

First Affiliated Hospital of Ningbo University

Ningbo, Zhejiang, China

Site Status

Ningbo Ninth Hospital

Ningbo, Zhejiang, China

Site Status

Xiangshan County Traditional Chinese Medicine Hospital Healthcare Group

Ningbo, Zhejiang, China

Site Status

Shengzhou People's Hospital

Shanhu, Zhejiang, China

Site Status

Countries

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China

Other Identifiers

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2024-0405

Identifier Type: -

Identifier Source: org_study_id

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