Corticosteroid Injections and Mid-Term Outcomes in Type 2 Diabetes Mellitus Patients with Adhesive Capsulitis

Corticosteroid Injections and Mid-Term Outcomes in Type 2 Diabetes Mellitus Patients with Adhesive Capsulitis

Stephen C. Weber, MD, UNITED STATES Eve R. Glenn, ScB, UNITED STATES Alexander R. Zhu, BA, UNITED STATES James H. Padley, BS, UNITED STATES Henry Fox, MD, UNITED STATES Necati Bahadir Eravsar, MD, TURKEY Edward G. McFarland, MD, FAAOS, UNITED STATES

The Johns Hopkins School of Medicine, Baltimore, Maryland, UNITED STATES


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Anatomic Location

Diagnosis / Condition

Treatment / Technique

Anatomic Structure


Summary: Type 2 diabetes patients reported poorer outcomes and higher rates of therapeutic interventions


Introduction

Adhesive capsulitis (frozen shoulder) restricts shoulder motion and accounts for 2-5% of shoulder pain cases. Comorbidities such as diabetes mellitus (DM) increase its risk. Type 2 diabetes mellitus (T2DM) causes systemic inflammation and complications. This study evaluates the short-term effects of corticosteroid injections in T2DM patients with newly diagnosed adhesive capsulitis.

Materials And Methods

Using the TriNetX Research Network, this retrospective study included T2DM patients with a first-time diagnosis of adhesive capsulitis. Two cohorts were identified based on the receipt of intra-articular corticosteroid injections within six months of diagnosis. Propensity score matching was performed to compare outcomes such as joint pain, arthrocentesis, shoulder arthroscopy, infections, and shoulder stiffness over 6 months to 1 year post-injection.

Results

The study included 59,054 T2DM patients with adhesive capsulitis, of whom 3,820 received injections within 6 months. After matching, each cohort comprised 3,819 patients. The Injection Cohort exhibited higher rates of joint pain, arthrocentesis, and shoulder arthroscopy compared to the No Injection Cohort.

Discussion

T2DM patients receiving corticosteroid injections for adhesive capsulitis reported poorer outcomes, including increased joint pain and higher rates of arthrocentesis and shoulder arthroscopy, compared to those who did not receive injections. These findings suggest that T2DM patients may respond differently to corticosteroid treatment, highlighting the need for cautious administration and consideration of alternative treatments.