Lin Che-Li, Lee Yu-Hao, Chen Yi-Wen, Liao Chun-De, Huang Shih-Wei
From the Department of Orthopedic Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (C-LL); Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (C-LL); Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan (Y-HL, Y-WC, C-DL, S-WH); Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (Y-HL, Y-WC, S-WH); and International Ph.D. Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan (C-DL).
Am J Phys Med Rehabil. 2024 Mar 1;103(3):215-221. doi: 10.1097/PHM.0000000000002340. Epub 2023 Sep 22.
Adhesive capsulitis affects the shoulder joint, causing pain and limiting motion. In clinical practice, the effectiveness of injections varies, and the factors influencing their success remain unclear. This study investigates the predictors of effective corticosteroid injections in patients with primary adhesive capsulitis.
This retrospective study enrolled adhesive capsulitis patients older than 35 yrs who received intra-articular corticosteroid injections. The response was determined based on patients' pain and range of motion 3 mos after the injection. Demographic data, medical comorbidities, and radiographic parameters (critical shoulder angle and acromial index) were compared between the effective and noneffective groups. Receiver operating characteristic curves and logistic regression were used to identify the predictors of injection effectiveness.
This study included 325 patients with primary adhesive capsulitis, who were divided into responder (189 patients, 58.2%) and nonresponder (136 patients, 41.8%) groups. The receiver operating characteristic curve revealed that the acromial index score indicated favorable discrimination for predicting a poor response to injections, whereas the critical shoulder angle score did not. Logistic regression revealed that the pain period, diabetes mellitus, and acromial index are predictors of nonresponders to injections.
Long pain duration, the presence of diabetes mellitus, and an acromial index score greater than 0.711 were predictors of nonresponse to corticosteroid injections for primary adhesive capsulitis patients.
粘连性关节囊炎影响肩关节，导致疼痛并限制活动。在临床实践中，注射治疗的效果各异，影响其成功的因素尚不清楚。本研究调查原发性粘连性关节囊炎患者皮质类固醇注射有效率的预测因素。
这项回顾性研究纳入了年龄大于35岁且接受关节内皮质类固醇注射的粘连性关节囊炎患者。根据患者注射后3个月的疼痛情况和活动范围来确定反应。对有效组和无效组的人口统计学数据、合并症及影像学参数（临界肩角和肩峰指数）进行比较。采用受试者工作特征曲线和逻辑回归分析来确定注射有效性的预测因素。
本研究纳入325例原发性粘连性关节囊炎患者，分为反应者组（189例，58.2%）和无反应者组（136例，41.8%）。受试者工作特征曲线显示，肩峰指数评分对预测注射反应不佳具有良好的区分度，而临界肩角评分则不然。逻辑回归分析显示，疼痛持续时间、糖尿病和肩峰指数是注射无反应者的预测因素。
对于原发性粘连性关节囊炎患者，疼痛持续时间长、患有糖尿病以及肩峰指数评分大于0.711是皮质类固醇注射无反应的预测因素。
