Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea.
Department of Radiology, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Korea.
Int Orthop. 2021 Jun;45(6):1455-1461. doi: 10.1007/s00264-020-04909-y. Epub 2021 Jan 18.
Adhesive capsulitis of the hip (ACH) is likely that this condition had been previously encountered, but easily unrecognised. We investigated the clinical features of patients with ACH, the efficacy of ultrasound-guided intra-articular hydrodilatation, and the patients' prognosis.
We enrolled 84 patients (93 hips) who visited the outpatient clinic from August 2018 to November 2019. ACH was diagnosed by restricted range of motion and sharp pain when turning with the affected leg fixed on the ground. We evaluated patient demographics and associated intra-articular pathologies found on magnetic resonance angiography (MRA) images. Injections were performed twice at two week intervals with a mixture of 0.5% lidocaine (25 mL) and triamcinolone (40 mg; 1 mL) with capsular distension under ultrasound guidance. Patients were assessed before and after treatment using a visual analogue scale (VAS), hip disability and osteoarthritis outcome score (HOOS), hip range of motion (ROM), and distance from floor to knee (DFK) when sitting in the cross-legged position.
On MRA, 18 patients had abnormal findings (eight labral tears, seven abductor tendinosis, three primary arthrosis). The mean VAS decreased from 7.1 ± 1.1 to 0.8 ± 0.9 after the last injection, and the HOOS improved in all subsets. The mean DFK decreased from 17.9 ± 4.8 to 9.7 ± 2.8 cm, and passive ROM showed improvement, especially in flexion and rotation. In seven patients, symptom recurrence was reported a mean of 4.1 months after the latest injection, but no independent risk factor for recurrence was identified.
Based on these current observations, patients with ACH may receive relief from hip joint pain and experience improved function with a timely diagnosis and effective treatment.
髋关节粘连性囊炎（ACH）可能是以前遇到过但容易被忽视的疾病。我们研究了 ACH 患者的临床特征、超声引导下关节内液压扩张的疗效以及患者的预后。
我们招募了 2018 年 8 月至 2019 年 11 月期间在门诊就诊的 84 名患者（93 髋）。通过限制运动范围和在患侧下肢固定于地面时旋转时出现的锐痛来诊断 ACH。我们评估了患者的人口统计学特征和磁共振血管造影（MRA）图像上发现的关节内相关病变。在超声引导下，用 0.5%利多卡因（25 mL）和曲安奈德（40 mg；1 mL）的混合物进行两次注射，间隔两周，进行囊扩张。治疗前后使用视觉模拟量表（VAS）、髋关节残疾和骨关节炎结果评分（HOOS）、髋关节活动范围（ROM）和交叉腿坐姿时膝盖到地板的距离（DFK）评估患者。
在 MRA 上，18 名患者有异常发现（8 名盂唇撕裂，7 名外展肌肌腱炎，3 名原发性关节炎）。末次注射后 VAS 均值从 7.1 ± 1.1 降至 0.8 ± 0.9，所有亚组的 HOOS 均有所改善。DFK 均值从 17.9 ± 4.8 降至 9.7 ± 2.8 cm，被动 ROM 有所改善，特别是在屈曲和旋转方面。在 7 名患者中，末次注射后平均 4.1 个月出现症状复发，但未确定复发的独立危险因素。
根据这些当前的观察结果，及时诊断和有效治疗可能会缓解 ACH 患者的髋关节疼痛并改善其功能。
