Treatment Effects of Ultrasound-Guided Capsular Distension With Hyaluronic Acid in Adhesive Capsulitis of the Shoulder

Park, Ki Deok; Nam, Hee-Seung; Lee, Ju Kang; Kim, Young Joo; Park, Yongbum

doi:10.1016/j.apmr.2012.10.002

Cited by 55 publications

(83 citation statements)

References 29 publications

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“…In the most severe cases, the addition of small doses of triamcinolone acetonide exploits the favorable effect on the sliding planes. The results of our study -resolution of the clinical picture in 96.1% of cases after a mean of 5-7 weeks of treatment -were found to be superior to ones previously reported in the literature (4,11,13,15,17,19). Therefore, in our opinion, surgical treatment of adhesive capsulitis should be reserved for cases resistant to conservative treatment, which in the present study accounted for only 3.8 % of the treated patients.…”

Section: Discussioncontrasting

confidence: 33%

“…The protocol used in the present study is supported by literature data on the use of combined rehabilitation and pharmacological approaches. Capsular distension induced by hyaluronic acid has been shown to be more effective than treatment with steroids, especially in terms of recovery of external rotation, assessed at two weeks and at six weeks after the last injection (11). Harris e al.…”

Section: Discussionmentioning

confidence: 99%

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Conservative integrated treatment of adhesive capsulitis of the shoulder

Russo¹,

Arrighi

Vignale³

et al. 2014

jts

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Purpose: the aim of this study was to present the results of a conservative treatment for adhesive capsulitis based on an original protocol of combined pharmacological and rehabilitation treatment. Methods: fifty-two patients with idiopathic adhesive capsulitis were enrolled in the present study. The treatment protocol included the use of hyaluronic acid and anaesthetic periarticular and intra-articular injections followed by a specific program of capsule and muscle stretching. Results: the results of this treatment showed complete recovery of range of motion (ROM) in 50 of the 52 cases. The mean pre-treatment ROM values were: 85°f or forward elevation, 75° for abduction, 25° for external rotation, and 15° for internal rotation. The posttreatment mean ROM values showed marked improvements: 175° for forward elevation, 175° for abduction, 87.5° for external rotation and 75° for internal rotation. Conclusions: conservative treatment of adhesive capsulitis based on a combined pharmacological and rehabilitation approach was found to be effective in resolving pain and stiffness in 96% of the patients. Level of evidence: level IV, therapeutic case series.

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Section: Discussioncontrasting

confidence: 33%

Section: Discussionmentioning

confidence: 99%

Conservative integrated treatment of adhesive capsulitis of the shoulder

Russo¹,

Arrighi

Vignale³

et al. 2014

jts

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“…This method allows for improvement of shoulder motion and pain with a deceased time to funcConclusion Ultrasonography-guided capsular distension by a posterolateral approach has similar effects to fluoroscopy-guided capsular distension by an anterior approach. Keywords Adhesive capsulitis, Injectiontional recovery [11,12,13]. …”

Section: Introductionmentioning

confidence: 99%

Randomized Controlled Trial for Efficacy of Capsular Distension for Adhesive Capsulitis: Fluoroscopy-Guided Anterior Versus Ultrasonography-Guided Posterolateral Approach

et al. 2014

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ObjectiveTo 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.MethodsParticipants 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.ResultsSPADI, 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.ConclusionUltrasonography-guided capsular distension by a posterolateral approach has similar effects to fluoroscopy-guided capsular distension by an anterior approach.

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“…44 This treatment showed improvement in clinical outcome, both in terms of pain reduction and increased mobility. 45 Another possibility is to obtain a capsular distension with lidocaine and hyaluronic acid; according to Park et al, 46 this option is as effective as steroid injection in pain relief and functional improvement.…”

Section: Intra-articular Injections and Hyaluronic Supplementation Ofmentioning

confidence: 99%