Hydrodilatation

This treatment was pioneered in Australia at Victoria House in 1989. Each year, approximately 4000 Hydrodilatations are performed at Victoria House. This is a simple procedure whereby the joint capsule is anaesthetised and stretched. 

 

PURPOSE 

The purpose of the treatment is to improve mobility of the shoulder joint and decrease pain in the shoulder. 

 

THE PROCEDURE 

The radiologist (doctor) assisted by a radiographer or nurse will perform the treatment. You will be lying on an X-Ray table throughout the procedure. 

The skin is sterilised with antiseptic and using X-Ray guidance a fine needle is placed into the shoulder joint. Through this needle, a small amount of contrast medium (iodine or air), some local anaesthetic and 1ml of steroid (Cortisone) will be injected into the joint. 

Then up to 40ml of sterile saline will be injected through the same needle to stretch the joint capsule (space). 

This may cause a feeling of tightness, increased pressure or heaviness in the shoulder or down the arm. A minority of people may experience some pain and should let staff know if this occurs. The procedure itself takes less than 10 minutes. 

 

PRECAUTIONS 

Please inform us: 

1. If you are allergic to X-ray contrast (iodine) or other medications. 

2. If you have congenital heart disease, a prosthetic heart valve, a history of endocarditis or heart transplant. (Your referring doctor or cardiologist may prescribe prophylactic antibiotics.) 

3. If, on the day of the procedure, you are unwell (particularly with a bad cold or ‘flu’) or are on antibiotics please contact the department to postpone your appointment until you are well. This will decrease the risk of infection. 

4. If you are breast feeding. (A small amount of cortisone may pass into the breast milk) 

5. If you are diabetic

 

SIDE EFFECTS 

1. You may get a flushed, red face similar in appearance to sunburn and occasionally you may feel a bit unwell. These symptoms may start the day after the procedure and can last for 2-3 days. It clears by itself or you can take an antihistamine tablet. 

2. Insulin-dependent diabetics may notice a moderate rise in blood sugar for up to 10 days after the injection. Some patients report an extreme rise in blood sugar. If you are unable to manage your own blood sugar, please consult your diabetic doctor/specialist immediately or you may like to seek their advice prior to the procedure. 

3. Clumsy and weak arm. This is quite normal and usually only lasts for an hour or so but can last for 24 hours. This is the reason why we ask you not to drive immediately after the procedure. You may drive again as soon as your arm feels normal and behaves normally. 

 

COMPLICATIONS 

Infection is the only serious complication that may occur. It is rare. The incidence of infection following steroid injection is in the order of 1 in 10,000 injections. If your shoulder feels hot and you are unwell with ‘flu’ like symptoms one to four days after the procedure, please go and see your local doctor. We advise you not to book in to have the procedure immediately prior to an important engagement or overseas travel as if you have a reaction to the procedure, it will be inconvenient and you may need to access first class medical care which is not always available at overseas destinations. 

 

AFTER THE PROCEDURE 

You are welcome to sit in the department for awhile following the procedure. Ideally, organise someone to drive you to and from Victoria House or take public transport. Otherwise we advise you to wait at least half an hour before driving, as you may find that your arm is uncoordinated and clumsy following the procedure. Some people start to feel faint 5-10 minutes after the procedure and we don’t want you to be driving a car should this happen to you. 

The shoulder may feel “squelchy” for a day or so. Once the local anaesthetic has worn off (after about 4 hours) there may be an ache in the shoulder for 1-2 days. 

Whether or not the procedure is successful will usually be known within two weeks. During this time you should consult your referring doctor or physiotherapist for any advice, particularly with regard as to how much you can use your arm. As a general rule it is best to avoid heavy lifting and intense activity of the shoulder for the first 3 days following the procedure. Gentle movements of the shoulder are advantageous. 

 

QUESTIONS 

If you have any queries regarding this procedure, please contact our staff on 9529 7333 

Download Patient Information Sheet (PDF)