From the Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan (C-YY, C-CL, C-LC, J-CW); Department of Neurology, Columbia University, New York, New York (C-YY); Department of Biomedical Informatics, Columbia University, New York, New York (L-HF); Division of General Surgery, Department of Surgery, Shin-Kong Memorial Hospital, Taipei, Taiwan (KAW); and Department of Physical Medicine and Rehabilitation, National Yang Ming University, Taipei, Taiwan (C-LC, J-CW).
Am J Phys Med Rehabil. 2020 Aug;99(8):719-724. doi: 10.1097/PHM.0000000000001400.
Glenohumeral joint hydrodilatation with corticosteroids has been proposed as an effective secondary therapeutic procedure for primary adhesive capsulitis. However, little is known about which subgroup of patients would benefit from this procedure. This study aimed to identify covariates associated with improved prognosis in patients receiving ultrasound-guided hydrodilatation with corticosteroid injection.
This was a cohort study. Data on baseline demographic characteristics, disease status, past medical conditions, and initial ultrasonographic findings were collected. Linear and logistic regression analyses were performed to determine the prognostic factors associated with better clinical outcomes.
Fifty-three patients (54 shoulders) were included. Linear regression analysis showed that coracohumeral ligament thickness of less than 3 mm, use of analgesics before hydrodilatation, and female sex were associated with good improvement in the Shoulder Pain and Disability Index score. Multivariate logistic regression analysis showed that coracohumeral ligament thickness of less than 3 mm on ultrasound was associated with a strong tendency (P = 0.054) of reaching the minimal detectable change. In addition, capsule rupture did not play a role in determining the clinical efficacy of hydrodilatation.
In patients with primary adhesive capsulitis, coracohumeral ligament thickness of less than 3 mm is correlated with greater short-term improvement in the Shoulder Pain and Disability Index score after ultrasound-guided hydrodilatation with steroid injection is performed.
冈上肌腱下囊糖皮质激素关节液压扩张术已被提议作为原发性粘连性囊炎的有效二级治疗方法。然而,对于哪些亚组患者将受益于该方法知之甚少。本研究旨在确定接受超声引导下糖皮质激素注射液压扩张术的患者中与改善预后相关的协变量。
这是一项队列研究。收集了基线人口统计学特征、疾病状况、既往病史和初始超声检查结果的数据。进行线性和逻辑回归分析,以确定与临床结果改善相关的预测因素。
共纳入 53 例患者(54 肩)。线性回归分析显示,喙肱韧带厚度<3mm、液压扩张前使用止痛药和女性与肩痛和残疾指数评分的显著改善相关。多变量逻辑回归分析显示,超声显示喙肱韧带厚度<3mm 与达到最小可检测变化的强烈趋势(P=0.054)相关。此外,囊破裂在确定液压扩张的临床疗效方面不起作用。
在原发性粘连性囊炎患者中,超声引导下糖皮质激素注射液压扩张术后,喙肱韧带厚度<3mm 与肩痛和残疾指数评分的短期改善显著相关。