Byun Seung Deuk, Park Dong Hwi, Choi Won Duck, Lee Zee Ihn
Department of Rehabilitation Medicine, Dae-gu Fatima Hospital, Daegu 701-600, Korea.
Ann Rehabil Med. 2011 Oct;35(5):664-72. doi: 10.5535/arm.2011.35.5.664. Epub 2011 Oct 31.
To investigate the additive effect of sono-guided subacromial bursa injection of hyaluronate with steroid in patients with peri-articular shoulder disorders.
This prospective randomized controlled trial involved 26 patients who had shoulder pain. Group A, consisting of 13 patients, was treated with a sono-guided subacromial bursa injection containing a mixture of 0.5% lidocaine (5 ml) and triamcinolone 40 mg (1 ml), followed by injection with sodium hyaluronate (2 ml) once a week for 3 weeks. The other 13 patients (Group B) were treated with a sono-guided subacromial bursa injection containing a mixture of 0.5% lidocaine (5 ml) and triamcinolone 40 mg (1 ml) once a week for 3 weeks. The effects were assessed using a visual analogue scale (VAS) of shoulder pain, active range of motion (AROM), shoulder function assessment scale (SFA), shoulder disability questionnaire (SDQ) at study entry and every week from first injection until 4 weeks after the 1(st) injection (= 2 weeks after 3(rd) injection).
(1) Demographic features and all parameters measured before injection did not show a significant difference between the 2 groups. (2) Statistically significant improvements were shown in VAS, SFA, SDQ during the 1(st), 2(nd), and 4(th) week after the first injection in both groups (p<0.05). (3) SFA showed significant improvement at 1 week after injection only in group A (p<0.05). (4) AROM of internal rotation showed significant improvement at week 4 after the 1(st) injection only in group A (p<0.05).
Subacromial bursa injection of hyaluronate with steroid in patients with peri-articular shoulder disorders has additive effects on functional improvement of the affected shoulder, including the AROM of internal rotation.
探讨超声引导下肩峰下滑囊注射透明质酸联合类固醇对肩关节周围疾病患者的附加效果。
这项前瞻性随机对照试验纳入了26例肩部疼痛患者。A组由13例患者组成,接受超声引导下肩峰下滑囊注射,其中含有0.5%利多卡因(5毫升)和曲安奈德40毫克(1毫升)的混合物,随后每周注射一次透明质酸钠(2毫升),共3周。另外13例患者(B组)接受超声引导下肩峰下滑囊注射,其中含有0.5%利多卡因(5毫升)和曲安奈德40毫克(1毫升),每周一次,共3周。在研究开始时以及从首次注射直至首次注射后4周(即第三次注射后2周)的每周,使用肩部疼痛视觉模拟量表(VAS)、主动活动范围(AROM)、肩部功能评估量表(SFA)、肩部残疾问卷(SDQ)评估效果。
(1)两组患者的人口统计学特征和注射前测量的所有参数均无显著差异。(2)两组在首次注射后的第1、2和4周,VAS、SFA、SDQ均有统计学意义的显著改善(p<0.05)。(3)仅A组在注射后1周时SFA有显著改善(p<0.05)。(4)仅A组在首次注射后第4周时内旋的AROM有显著改善(p<0.05)。
对于肩关节周围疾病患者,肩峰下滑囊注射透明质酸联合类固醇对患肩功能改善有附加效果,包括内旋的AROM。