Intra-Articular Versus Periarticular Acromioclavicular Joint Injection: A Multicenter, Prospective, Randomized, Controlled Trial

Sabeti-Aschraf, Manuel; Stotter, Christoph; Thaler, Christoph; Kristen, Karl-Heinz; Schmidt, Maximilian; Krifter, Rolf Michael; Hexel, M; Ostermann, Roman C.; Hofstaedter, Thomas; Gráf, Alexandra; Windhager, Reinhard

doi:10.1016/j.arthro.2013.08.027

Cited by 20 publications

(14 citation statements)

References 11 publications

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“…19 On the contrary, two randomized controlled trials reported that although US guidance led to a higher success rate of intra-articular injection, the clinical outcome was not better than periarticular or palpation-guided injections. 20 , 21 The above studies suggest that while US-guided AC joint injection definitely allows precise intra-articular administration of the injectate, there is still uncertainty regarding treatment outcomes compared with the palpation-guided approach.…”

Section: Ac Jointmentioning

confidence: 99%

Ultrasound-guided interventions for painful shoulder: from anatomy to evidence

Chang¹,

Mezian²,

Naňka³

et al. 2018

JPR

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Shoulder pain is a common musculoskeletal disorder of variable etiology, ranging from rotator cuff pathology to peripheral nerve entrapment. Advances in ultrasound (US) technology have allowed static and dynamic evaluation of shoulder problems and most importantly, offer real-time, radiation-free guidance for interventions. The present review aims to describe shoulder anatomy in detail using information from cadaveric models and to illustrate US-guided techniques using clearly labeled figures and videos. The review will also present evidence of specific US-guided therapies for shoulder pain by summarizing landmark studies, systematic reviews, and meta-analyses. The following shoulder structures will be covered: 1) the biceps long head tendon, 2) the acromioclavicular joint, 3) the subacromial–subdeltoid bursa, 4) the glenohumeral joint, 5) the suprascapular nerve, and 6) the axillary nerve.

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Section: Ac Jointmentioning

confidence: 99%

Ultrasound-guided interventions for painful shoulder: from anatomy to evidence

Chang¹,

Mezian²,

Naňka³

et al. 2018

JPR

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“…Successful intra-articular localization may not provide a clear benefit to patients with a symptomatic acromioclavicular joint. In a multicenter, prospective, controlled trial of 101 patients with a symptomatic acromioclavicular joint who were randomized to ultrasonography-guided intra-articular or periarticular injection of 1 mL of betamethasone with local anesthetic, Sabeti-Aschraf et al 30 reported a significant clinical improvement in all the patients at 1 hour, 1 week, and 3 weeks postoperatively. At 3 weeks postoperatively, the authors reported no significant differences in visual analog scale pain scores, Constant-Murley scores, and local tenderness to palpation between the patients in the two groups; however, better pain reduction based on the crossover arm test was reported in the patients in the intra-articular injection group.…”

Section: Acromioclavicular Jointmentioning

confidence: 99%

Clinical Applications of Ultrasonography in the Shoulder and Elbow

Lin

Gasbarro

Sakr

2018

J Am Acad Orthop Surg

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In the past 30 years, the use of ultrasonography in the field of orthopaedics has evolved. As ultrasonography has been refined, smaller machines with higher fidelity and better transducers have become available at a lower cost. Diagnostic and therapeutic applications of ultrasonography in the shoulder and elbow have expanded imaging options and provided alternatives to surgical management. Ultrasonography is a dynamic tool that affords immediate diagnostic assessment for clinical correlation and can be used for serial examinations and image guidance during therapeutic procedures. This imaging modality is highly reliable and accurate and may limit the need for costly imaging referrals, particularly in geographic areas where advanced imaging is not readily available. However, clinical expertise is paramount for ultrasonography, which is an operator-dependent modality. Ultrasonography is an effective educational resource; therefore, the curriculum in orthopaedic residency training programs should include education on this modality as the use of ultrasonography increases among orthopaedic surgeons.

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“…There were no significant differences between both groups, with the investigators proposing a poorer than expected result in the US guided group could be secondary to cartilage or meniscoid damage as a result of precise guidance of the needle into the joint. In addition, Sabeti-Aschraf et al 21 conducted a multi-centered controlled trial with 106 symptomatic arthritic ACJs to compare the efficacy of intra-articular and peri-articular joint injections. Outcomes were measured at 1 hour, 1 week and 3 weeks post-injection and recorded using the Constant-Murley score, cross-over arm test and visual analogue scale (VAS) to assess pain on palpation and pain at night.…”

Section: Therapeutic Injectionsmentioning

confidence: 99%