Randomized Controlled Trial for Efficacy of Capsular Distension for Adhesive Capsulitis: Fluoroscopy-Guided Anterior Versus Ultrasonography-Guided Posterolateral Approach
´ëÇÑÀçÈ°ÀÇÇÐȸÁö 2014³â 38±Ç 3È£ p.360 ~ p.368
¹èÀçÇö(Bae Jae-Hyun) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Physical Medicine and Rehabilitation
¹Ú¿µ¼÷(Park Young-Sook) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Physical Medicine and Rehabilitation
ÀåÇöÁ¤(Chang Hyun-Jung) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Physical Medicine and Rehabilitation
±è¹ÎÁß(Kim Min-Jung) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Physical Medicine and Rehabilitation
(Park Kang-Young) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Physical Medicine and Rehabilitation
Áø½Âȯ(Jin Seung-Hwan) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Physical Medicine and Rehabilitation
ÀÌÀºÈñ(Lee Eun-Hee) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Pathology
Abstract
Objective: To find the most effective procedure to treat adhesive capsulitis of the shoulder, we evaluated the clinical effects of an ultrasonographic-guided anterior approach capsular distension and a fluoroscopy-guided posterolateral approach capsular distension. We expected the anterior approach to be better than the posterolateral approach because the rotator interval, a triangular anatomic area in the anterosuperior aspect of the shoulder, which is considered an important component of the pathology of adhesive capsulitis.
Methods: Participants were randomly assigned to two groups: 27 patients in group A were injected by an anterior approach with 2% lidocaine (5 mL), contrast dye (5 mL), triamcinolone (40 mg), and normal saline (9 mL) under fluoroscopic guidance in the operating room. Twenty-seven patients in group B were injected using a posterolateral approach with 2% lidocaine (5 mL), triamcinolone (40 mg), and normal saline (14 mL) under ultrasonographic guidance. After injection, all patients received physiotherapy four times in the first postoperative week and then two times each week for eight more weeks. Treatment effects were assessed using the shoulder pain and disability index (SPADI), visual numeric scale (VNS), passive range of motion (PROM), hand power (grip and pinch) at baseline and at one week, five and nine weeks after injection.
Results: SPADI, VNS, PROM, and hand power improved in one week, five and nine weeks in both groups. Statistically significant differences were not observed in SPADI, VNS, PROM, or hand power between groups.
Conclusion: Ultrasonography-guided capsular distension by a posterolateral approach has similar effects to fluoroscopy-guided capsular distension by an anterior approach.
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Adhesive capsulitis, Injection
KMID :
0361420140380030360
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