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超声引导下液压扩张治疗粘连性肩周炎的团队协作方法:一项回顾性研究。

A team approach to adhesive capsulitis with ultrasound guided hydrodilatation: a retrospective study.

作者信息

Dakkak Michael, Genin Jason, Wichman Lauren, Zhang Chao, Patel Vikas

机构信息

Department of Orthopaedic Surgery, Cleveland Clinic Foundation Florida, Weston, FL, USA.

Cleveland Clinic Foundation, Cleveland, OH, USA.

出版信息

Pain Manag. 2024 Dec;14(12):633-640. doi: 10.1080/17581869.2024.2435803. Epub 2024 Nov 29.

Abstract

BACKGROUND

Adhesive capsulitis (AC) causes shoulder pain and limited range of motion. While ultrasound-guided suprascapular nerve block, glenohumeral joint hydrodilatation, and physical therapy are effective individually, their combined use is not well-studied.

OBJECTIVE

This study evaluates the effect and safety of combining ultrasound-guided suprascapular nerve block, glenohumeral joint hydrodilatation, and physical therapy on range of motion and pain, comparing diabetic and non-diabetic patients.

DESIGN

Retrospective Cohort; Level of Evidence 3.

METHODS

150 patients (30-75 years) with AC received ultrasound-guided suprascapular nerve block, glenohumeral joint hydrodilatation with corticosteroid injection, and subsequent physical therapy. Baseline Visual Analog Scale (VAS) pain score, active forward flexion, and external rotation range of motion were measured using a goniometer. At 3 months post-procedure, range of motion and pain were reevaluated.

RESULTS

Significant improvements in active forward flexion (median improvement of 25 degrees) and external rotation (median improvement of 19 degrees) were observed at 3 months ( < 0.001). No complications were reported.

CONCLUSION

Combining ultrasound-guided suprascapular nerve block, glenohumeral joint hydrodilatation, and physical therapy is safe, effective, and improves pain, flexion, and external rotation range of motion in patients with adhesive capsulitis.

摘要

背景

粘连性肩关节囊炎(AC)会导致肩部疼痛和活动范围受限。虽然超声引导下肩胛上神经阻滞、盂肱关节液压扩张和物理治疗单独使用时均有效,但它们联合使用的效果尚未得到充分研究。

目的

本研究评估超声引导下肩胛上神经阻滞、盂肱关节液压扩张和物理治疗联合应用对活动范围和疼痛的效果及安全性,并比较糖尿病患者和非糖尿病患者。

设计

回顾性队列研究;证据等级为3级。

方法

150例年龄在30 - 75岁的粘连性肩关节囊炎患者接受了超声引导下肩胛上神经阻滞、皮质类固醇注射的盂肱关节液压扩张以及后续的物理治疗。使用角度计测量基线视觉模拟评分(VAS)疼痛评分、主动前屈和外旋活动范围。在治疗后3个月,重新评估活动范围和疼痛情况。

结果

在3个月时观察到主动前屈(中位改善25度)和外旋(中位改善19度)有显著改善(<0.001)。未报告并发症。

结论

超声引导下肩胛上神经阻滞、盂肱关节液压扩张和物理治疗联合应用是安全、有效的,可改善粘连性肩关节囊炎患者的疼痛、前屈和外旋活动范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c412/11703283/362578e2ac41/IPMT_A_2435803_F0001_B.jpg

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