Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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A Randomized Comparative Study of Blind versus Ultrasound Guided Glenohumeral Joint Injection of Corticosteroids for Treatment of Shoulder Stiffness

  • Lee, Hyo-Jin (Department of Orthopedic Surgery, Wonkwang University Sanbon Hospital, Wonkwang University of School of Medicine) ;
  • Ok, Ji-Hoon (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, School of Medicine, The Catholic University of Korea) ;
  • Park, In (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, School of Medicine, The Catholic University of Korea) ;
  • Bae, Sung-Ho (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, School of Medicine, The Catholic University of Korea) ;
  • Kim, Sung-Eun (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, School of Medicine, The Catholic University of Korea) ;
  • Shin, Dong-Jin (Department of Orthopedic Surgery, Wonkwang University Sanbon Hospital, Wonkwang University of School of Medicine) ;
  • Kim, Yang-Soo (Department of Orthopedic Surgery, Wonkwang University Sanbon Hospital, Wonkwang University of School of Medicine)
  • Received : 2014.09.29
  • Accepted : 2014.12.28
  • Published : 2015.09.30
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Abstract

Background: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. Methods: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. Results: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at $90^{\circ}$ abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). Conclusions: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.

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References

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