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关节镜引导下关节内注射治疗粘连性肩关节囊炎的疗效观察。

Good results after fluoroscopic-guided intra-articular injections in the treatment of adhesive capsulitis of the shoulder.

机构信息

Department of Orthopedic and Trauma Surgery, Klinikum Osnabrück, Am Finkenhügel 1, 49076 Osnabrück, Germany.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2010 Oct;18(10):1435-41. doi: 10.1007/s00167-009-1030-7. Epub 2010 Jan 14.

Abstract

The purpose of the present study was the prospective evaluation of the results of fluoroscopic-guided intra-articular cortisone injection series in the treatment of adhesive capsulitis of the shoulder. Twenty-five patients (9 m, 16 w) with a mean age of 49 ± 8 years and stage II frozen shoulder syndrome according to the Reeves classification were treated with an intra-articular cortisone injection series (3 injections at 0, 4, 12, weeks). Clinical examination, ASES score and SF 36 score were performed at 0, 4, 8, 12 weeks, 6 and 12 months. In the results, significant improvements were seen in flexion (99 ± 30°-119 ± 31°, P < .0001), abduction (72 ± 24-99 ± 34°, P < .0001), external rotation (14 ± 16°-28 ± 21°, P < .0001) and internal rotation already at first follow-up after 4 weeks of treatment. The results were confirmed at any other follow-up. ASES score improved from 28 ± 13 to 45 ± 18 after 4 weeks (P < .0001), 59 ± 21 after 8 weeks (P < .0001), 63 ± 25 at 3 months (P < .0001), 64 ± 28 (P < .0001) at 6 months and 73 ± 27 (P < .0001) points at final follow-up after 1 year. Evaluation of the SF-36 Score showed significant improvements in almost all categories (physical and mental) after 4 weeks of treatment (P < .05). In conclusion, a fluoroscopic-guided intra-articular injection series of cortisone is an effective treatment option in frozen shoulder syndrome leading to a fast pain reduction and increased range motion.

摘要

本研究的目的是前瞻性评估关节内皮质激素注射系列在治疗粘连性肩关节囊炎中的结果。25 名患者(9 名男性,16 名女性),平均年龄 49 ± 8 岁,根据 Reeves 分类为 II 期冻结肩综合征,接受关节内皮质激素注射系列(0、4、12 周时 3 次注射)治疗。在 0、4、8、12 周、6 和 12 个月时进行临床检查、ASES 评分和 SF-36 评分。结果显示,治疗后 4 周时,屈曲(99 ± 30°-119 ± 31°,P<.0001)、外展(72 ± 24°-99 ± 34°,P<.0001)、外旋(14 ± 16°-28 ± 21°,P<.0001)和内旋明显改善。在任何其他随访中,结果均得到证实。治疗后 4 周时 ASES 评分从 28 ± 13 提高到 45 ± 18(P<.0001),8 周时提高到 59 ± 21(P<.0001),3 个月时提高到 63 ± 25(P<.0001),6 个月时提高到 64 ± 28(P<.0001),1 年后最终随访时提高到 73 ± 27(P<.0001)。SF-36 评分评估显示,治疗后 4 周时几乎所有类别(身体和精神)均有显著改善(P<.05)。总之,关节内皮质激素注射系列是治疗冻结肩综合征的有效选择,可快速减轻疼痛并增加活动范围。

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