Kurta Illona, Datir Sandeep, Dove Michael, Rahmatalla Aziz, Wynn-Jones Charles, Maffulli Nicola
North Staffordshire Hospital Trust, Stoke-on-Trent, UK.
Acta Orthop Belg. 2005 Dec;71(6):656-61.
This study is aimed at evaluating the short-term effects of a single corticosteroid injection of the acromioclavicular joint on the range of motion of the shoulder joint using a three dimensional electromagnetic tracking system (FASTRAK) in patients with isolated unilateral acromioclavicular joint (ACJ) arthropathy. Eighteen patients (16 male, 2 female; mean age: 47.53 years), with isolated unilateral ACJ arthropathy were included in the study. Injection of the symptomatic ACJ with local anaesthetic and corticosteroid was performed under image intensifier guidance. Bilateral shoulder FASTRAK assessment before and two weeks after injection of the symptomatic ACJ was performed, measuring flexion/extension, anatomical abduction, scapular abduction and horizontal cross body adduction. Pain was measured using a visual analogue scale. There was a significant difference in the range of movement between the symptomatic and asymptomatic shoulder before the injection (p < 0.01). Range of extension and pain score of the symptomatic shoulder improved significantly (p < 0.05 and p < 0.001, respectively) after the injection. In patients with radiographical evidence of degenerative ACJ disease, there was also significant improvement in the range of horizontal flexion (p < 0.05). Injection of the ACJ with local anaesthetic and corticosteroid was found to produce short-term pain relief and partial improvement in the range of movement. FASTRAK is useful in the measurement and documentation of range of motion, and can be used to assess the treatment outcome in patients with isolated ACJ arthropathy.
本研究旨在使用三维电磁跟踪系统(FASTRAK)评估单次皮质类固醇注射肩锁关节对孤立性单侧肩锁关节(ACJ)病患者肩关节活动范围的短期影响。18例孤立性单侧ACJ病患者(16例男性,2例女性;平均年龄:47.53岁)纳入本研究。在影像增强器引导下,对有症状的ACJ注射局部麻醉剂和皮质类固醇。在注射有症状的ACJ之前及之后两周,对双侧肩部进行FASTRAK评估,测量屈伸、解剖外展、肩胛外展和水平交叉内收。使用视觉模拟量表测量疼痛程度。注射前,有症状肩部与无症状肩部的活动范围存在显著差异(p < 0.01)。注射后,有症状肩部的伸展范围和疼痛评分显著改善(分别为p < 0.05和p < 0.001)。在有退行性ACJ病影像学证据的患者中,水平屈曲范围也有显著改善(p < 0.05)。发现对ACJ注射局部麻醉剂和皮质类固醇可产生短期疼痛缓解,并使活动范围部分改善。FASTRAK在测量和记录活动范围方面很有用,可用于评估孤立性ACJ病患者的治疗效果。