- Volume 17 Issue 3
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Does Single Blind Anterior Glenohumeral Steroid Injection Performed by Short Experienced Clinicians Could Provide Clinical Efficacy in Patients with Frozen Shoulder?
Hong, Jin Ho;Ryu, Ho Young;Park, Yong Bok;Jeon, Sang Jun;Park, Won Ha;Yoo, Jae Chul
- Received : 2014.06.09
- Accepted : 2014.07.29
- Published : 2014.09.30
Background: The purpose of this study was to evaluate the effect of single blinded anterior intra-articular corticosteroid injection to the glenohumeral joint performed by short experienced clinicians in frozen state adhesive capsulitis patients. Methods: From March to June of 2013, among the patients who visited the shoulder outpatient clinic due to shoulder pain for 5-6 months and those patient diagnosed as frozen state adhesive capsulitis was selected. The diagnosis were based on base, first the global limitation of range of motion, defined as forward elevation <100, external rotation at side <10, internal rotation less than buttock, and abduction <70. Second, the patients had additional radiologic evaluations showing no major pathologies for such stiffness. Clinical outcome, were performed with pain visual analog scale (PVAS) and functional visual analog scale (FVAS), American Shoulder and Elbow Surgeons Shoulder score (ASES), preinjection and postinjection after 2-4 weeks. Finally 82-patients were enrolled. Mean age of the patients was 55.1 years and mean follow-up duration was 25.17 days. Results: The mean preinjection PVAS was 6.91 and postinjection was 3.11, there was 3.8 decreases from preinjection status (p < 0.001). The mean FVAS score showed 4.26 at preinjection and 6.63 afterwards (p < 0.001). The ASES score showed 27.89 increases after injection (p < 0.001). There were 64-patients (78.04%) who reported more than 3 points of decrease of PVAS, who could be judged as effective treatment. Conclusions: Single anterior glenohumeral steroid injection by short experienced clinicians to the patients with frozen state adhesive capsulitis has shown relatively high efficacy in clinical result evaluated by means of PVAS.
Shoulder;Adhesive capsulitis;Glucocorticoid;Intra-articular injections
- Sethi PM, Kingston S, Elattrache N. Accuracy of anterior intraarticular injection of the glenohumeral joint. Arthroscopy. 2005;21(1):77-80. https://doi.org/10.1016/j.arthro.2004.09.009
- Adebajo AO, Nash P, Hazleman BL. A prospective double blind dummy placebo controlled study comparing triamcinolone hexacetonide injection with oral diclofenac 50 mg TDS in patients with rotator cuff tendinitis. J Rheumatol. 1990;17(9):1207-10.
- Griesser MJ, Harris JD, Campbell JE, Jones GL. Adhesive capsulitis of the shoulder: a systematic review of the effectiveness of intra-articular corticosteroid injections. J Bone Joint Surg Am. 2011;93(18):1727-33. https://doi.org/10.2106/JBJS.J.01275
- Esenyel CZ, Ozturk K, Demirhan M, et al. Accuracy of anterior glenohumeral injections: a cadaver study. Arch Orthop Trauma Surg. 2010;130(3):297-300. https://doi.org/10.1007/s00402-008-0811-7
- Kraeutler MJ, Cohen SB, Ciccotti MG, Dodson CC. Accuracy of intra-articular injections of the glenohumeral joint through an anterior approach: arthroscopic correlation. J Shoulder Elbow Surg. 2012;21(3):380-3. https://doi.org/10.1016/j.jse.2011.06.013
- Oh JH, Oh CH, Choi JA, Kim SH, Kim JH, Yoon JP. Comparison of glenohumeral and subacromial steroid injection in primary frozen shoulder: a prospective, randomized short-term comparison study. J Shoulder Elbow Surg. 2011;20(7):1034-40. https://doi.org/10.1016/j.jse.2011.04.029
- Richards RR, An KN, Bigliani LU, et al. A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg. 1994;3(6):347-52. https://doi.org/10.1016/S1058-2746(09)80019-0
- Kang MN, Rizio L, Prybicien M, Middlemas DA, Blacksin MF. The accuracy of subacromial corticosteroid injections: a comparison of multiple methods. J Shoulder Elbow Surg. 2008;17(1 Suppl):61S-6S. https://doi.org/10.1016/j.jse.2007.07.010
- Marder RA, Kim SH, Labson JD, Hunter JC. Injection of the subacromial bursa in patients with rotator cuff syndrome: a prospective, randomized study comparing the effectiveness of different routes. J Bone Joint Surg Am. 2012;94(16):1442-7. https://doi.org/10.2106/JBJS.K.00534
- Tobola A, Cook C, Cassas KJ, et al. Accuracy of glenohumeral joint injections: comparing approach and experience of provider. J Shoulder Elbow Surg. 2011;20(7):1147-54. https://doi.org/10.1016/j.jse.2010.12.021
- McInerney JJ, Dias J, Durham S, Evans A. Randomised controlled trial of single, subacromial injection of methylprednisolone in patients with persistent, post-traumatic impingment of the shoulder. Emerg Med J. 2003;20(3):218-21. https://doi.org/10.1136/emj.20.3.218
- Withrington RH, Girgis FL, Seifert MH. A placebo-controlled trial of steroid injections in the treatment of supraspinatus tendonitis. Scand J Rheumatol. 1985;14(1):76-8. https://doi.org/10.3109/03009748509102022
- Blair B, Rokito AS, Cuomo F, Jarolem K, Zuckerman JD. Efficacy of injections of corticosteroids for subacromial impingement syndrome. J Bone Joint Surg Am. 1996;78(11):1685-9. https://doi.org/10.2106/00004623-199611000-00007