Proper site of corticosteroid injection for the treatment of idiopathic frozen shoulder: Results from a randomized trial

Cho, Chul-Hyun; Kim, Du Hwan; Bae, Ki-Cheor; Lee, Dong Gyu; Kim, Dong Kyu

doi:10.1016/j.jbspin.2015.06.014

Cited by 32 publications

(73 citation statements)

References 21 publications

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“…Some clinical trials have reported that corticosteroid injection into the SA bursa had an effect similar to that of IA injection in the treatment of idiopathic FS. [ 13 – 15 ] These results suggested that the SA bursa may be a potential pathologic lesion in idiopathic FS. However, there is no clear explanation as to whether the SA bursa is a major or minor clinical lesion.…”

Section: Discussionmentioning

confidence: 84%

“…Some randomized controlled trials have reported similar effects between the IA and SA treatments, [ 11 , 12 ] the other 2 randomized controlled trials claimed the superiority of IA injection up to 12 weeks for pain relieve and functional recovery compared to SA injection. [ 13 , 14 ] With injection of 40 mg of triamcinolone and 2 mL 2% lidocaine, Kim et al found RI injection was superior to IA in the early phase of FS. [ 15 ]…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness of intra-articular vs subacromial corticosteroid injection for frozen shoulder

Wang

Gong

2020

Medicine

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Background: Intra-articular (IA) corticosteroid injection is a commonly used therapy for frozen shoulder (FS), but controversy still exists regarding the injection site with the best outcome. This randomized controlled trial is designed to determine whether corticosteroid injection into the subacromial space was not inferior to IA injection in patients with FS. Methods: This study will be a single-center, randomized, and double-blinded trial. Sixty patients who meet inclusion criteria will be randomized in a ratio of 1:1 to either subacromial injection or IA injection group. The outcome evaluations will be conducted at 4 time points (baseline, 4, 8, and 12 weeks after the injection) by an independent physical therapist. The primary outcome measure is visual analog scale for pain, whereas the secondary outcomes include Constant score, and shoulder passive range of motion including abduction, forward elevation, external rotation at the side, and internal rotation at the side. Discussion: This study has limited inclusion and exclusion criteria and a well-controlled intervention. This clinical trial is expected to provide evidence of proper site of corticosteroid injection for the treatment of FS. Trial registration: This study protocol was registered in Research Registry (researchregistry5368).

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

The effectiveness of intra-articular vs subacromial corticosteroid injection for frozen shoulder

Wang

Gong

2020

Medicine

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“…However, the therapeutic benefits of the injection are largely affected by injection accuracy 6, 7. Glenohumeral injections are therefore often performed with imaging guidance to achieve high accuracy rates,2, 3 despite the drawbacks imaging guidance can confer.…”

Section: Discussionmentioning

confidence: 99%

“…Unguided glenohumeral injection techniques may offer an alternative to avoid such disadvantages; however, they may be less reliable with often lower accuracy rates compared with guided injection techniques 5 . To date, there is no established technique for an accurate and reproducible unguided glenohumeral injection, despite the benefits of an accurately targeted injection for patients with shoulder symptoms, such as improved responses to therapeutic medications and reduced injury to surrounding structures 6, 7. The purpose of this Technical Note is to describe an unguided transcoracoacromial ligament glenohumeral injection technique 8 that utilizes the geometry of bony surface landmarks for routine use in the outpatient clinic without radiographic guidance.…”

mentioning

confidence: 99%

Transcoracoacromial Ligament Glenohumeral Injection Technique Using Bony Surface Landmarks

Shi

Sohn

Shao

et al. 2019

Arthroscopy Techniques

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Intra-articular glenohumeral injection is an important technique used to diagnose and treat shoulder disorders. However, it is frequently performed as an image-guided technique with the use of fluoroscopy, ultrasound, computed tomography, or magnetic resonance. The purpose of this Technical Note is to describe a transcoracoacromial ligament glenohumeral injection technique that uses anatomic surface landmarks to avoid the need for radiographic guidance. After identification of the anterolateral corner of acromion, the superior lateral border of the coracoid tip, and the curved depression of the distal clavicle, the needle entry site is determined at the trisection point between the distal and middle thirds of the line formed by the superior lateral border of the coracoid tip and the curved depression of the distal clavicle. The needle is first inserted perpendicular to the triangular plane of the 3 points and is then advanced toward the humeral head. This injection technique is highly accurate and reproducible and can be done in the outpatient clinic without the use of imaging guidance, reducing the costs and barriers of intra-articular glenohumeral injections for patients.

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“…Data including the visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value (SSV), and passive ROMs [ 13 , 14 ] were collected prospectively before the injection and at 3, 6, and 12 weeks after the injection. The ROMs, including forward flexion, abduction, and external rotation were assessed by a goniometer in the sitting position.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Clinical Outcomes between Idiopathic Frozen Shoulder and Diabetic Frozen Shoulder After a Single Ultrasound-Guided Intra-Articular Corticosteroid Injection

2020

Self Cite

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There is no consensus on the use of intra-articular corticosteroid injections in diabetic frozen shoulder (FS). Thus, we aimed to compare clinical outcomes after intra-articular corticosteroid injections in patients with diabetic FS and idiopathic FS. Data collected from 142 FS patients who received glenohumeral joint intra-articular corticosteroid injections were retrospectively reviewed. Thirty-two patients were diagnosed with diabetic FS and 110 patients with idiopathic FS. Data including visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value (SSV), and passive range of motion (ROM) were compared before the injection and at 3, 6, and 12 weeks after the injection. There were significant improvements in all outcomes (p < 0.001 for all parameters) through 12 weeks in both groups. There were no significant differences in all outcomes, except for ASES scores, between both groups at 3 weeks. However, there were significant differences in VAS score, SSVs, ASES scores, and passive ROMs, except for angle of abduction, between the two groups at 6 weeks and 12 weeks after injection. A single intra-articular steroid injection can be used as a conservative treatment for diabetic FS, but less effective than for idiopathic FS.

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Proper site of corticosteroid injection for the treatment of idiopathic frozen shoulder: Results from a randomized trial

Cited by 32 publications

References 21 publications

The effectiveness of intra-articular vs subacromial corticosteroid injection for frozen shoulder

The effectiveness of intra-articular vs subacromial corticosteroid injection for frozen shoulder

Transcoracoacromial Ligament Glenohumeral Injection Technique Using Bony Surface Landmarks

Comparison of Clinical Outcomes between Idiopathic Frozen Shoulder and Diabetic Frozen Shoulder After a Single Ultrasound-Guided Intra-Articular Corticosteroid Injection

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