1
|
Rangra P, Dickson L, Jagadamma KC. Service evaluation: Three subjective questions that aid in identifying frozen shoulder-Within a multi-centre musculoskeletal physiotherapy department in primary care. Musculoskeletal Care 2024; 22:e1886. [PMID: 38643407 DOI: 10.1002/msc.1886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/22/2024]
|
2
|
Lin CL, Chuang TY, Lin PH, Wang KA, Chuang E, Wang JC. The comparative effectiveness of combined hydrodilatation/corticosteroid procedure with two different quantities for adhesive capsulitis. Clin Rehabil 2024; 38:600-611. [PMID: 38361324 DOI: 10.1177/02692155241227607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To assess the efficacy of injecting various amounts of fluid into the shoulder joints for capsule distension in patients with adhesive capsulitis. DESIGN A randomized controlled trial. SETTING Outpatient clinic of a tertiary care centre. PARTICIPANTS Eighty-four patients with adhesive capsulitis underwent a baseline (time0), 6 weeks (time1), and 12 weeks (time2) follow-up after hydrodilitation. INTERVENTION Group 1 (n = 42) received 20 ml of lidocaine, steroid, and saline hydrodilatation via posterior glenohumeral recess, while Group 2 (n = 42) received 10 ml of lidocaine, steroid, and saline hydrodilitation. MAIN MEASURES The primary outcome was the visual analogue scale for pain. The secondary outcomes were shoulder pain and disability index (SPADI) and ROM of the shoulder. RESULTS There was a significant reduce in VAS scores for pain, SPADI scores, and increased shoulder ROM in both groups over time; however, the group-by-time interactions for any of the outcomes between groups were not significant except VAS pain in motion. Post-hoc pairwise analysis of the marginal effect of time and group showed that the significant difference of VAS in motion is due to time effect: time1 vs time0 (95% CI -4.09 to -2.68), time2 vs time0 (-4.21 to -2.77), and time2 vs time1 (-0.83 to 0.63), without between-group difference: group 1 vs group 2 (-0.38 to 0.59). CONCLUSION Our study suggests hydrodilatation achieved an optimal effect at time1 for patients with adhesive capsulitis in both groups, and adding more saline offers additional benefits in flexion and external roatation until time2.
Collapse
Affiliation(s)
- Chien-Lin Lin
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung
| | - Tien-Yow Chuang
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung
| | - Pei-Hsin Lin
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei
- Center for Rehabilitation and Technical Aid, Taipei Veterans General Hospital, Taipei
| | - Kevin A Wang
- Divison of General Surgery, Department of Surgery, Shin-Kong Memorial Hospital, Taipei
| | - Eric Chuang
- Divison of General Surgery, Department of Surgery, New York University Langone Health, Brooklyn, NY, USA
| | - Jia-Chi Wang
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei
| |
Collapse
|
3
|
Teytelbaum DE, Kumar NS, Dent CS, Neaville S, Warren DH, Simon P, Baker CE. Efficacy of a high-intensity home stretching device and traditional physical therapy in non-operative management of adhesive capsulitis - a prospective, randomized control trial. BMC Musculoskelet Disord 2024; 25:305. [PMID: 38643086 PMCID: PMC11031861 DOI: 10.1186/s12891-024-07448-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 04/16/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Historically, in-person physical therapy serves as a foundational component of nonoperative treatment of adhesive capsulitis (AC). This study compares the effectiveness of an at-home high-intensity stretch (HIS) device to traditional physical therapy (PT) and to PT in combination with the HIS device. We hypothesize that the HIS device will be as effective as PT alone or as combination therapy in the first-line treatment of AC and use of the HIS device will exhibit improvement at higher rate. METHODS Thirty-four patients with idiopathic adhesive capsulitis and a minimum of 12 months follow-up were included in this study. Patients were randomized into one of the three groups: HIS device, PT alone, or HIS device + PT. Passive range of motion (ROM), American Shoulder and Elbow Surgeons (ASES), and Simple Shoulder Test (SST) scores were measured. Additionally, patient satisfaction, compliance and complications were recorded. Paired t-test, ANOVA and Chi-squared tests were used in analysis. RESULTS Final ROM in all planes improved for all groups compared to baseline (p < 0.001), with only HIS device group able to restore > 95% of contralateral ROM in all planes at final follow-up. Patients with PT alone were on average slowest to improve ROM from baseline, at 3 months, 6 months, and 1 year in all planes except internal rotation. ASES and SST scores improved for all groups when compared to baseline (p < 0.001). Use of HIS-device resulted in greater improvement in SST and ASES Total scores compared to PT alone (p = 0.045, and p = 0.048, respectively). CONCLUSIONS Use of an at-home high-intensity stretching device for conservative treatment of idiopathic adhesive capsulitis improves outcomes in ROM and in ASES and SST scores both when used as an adjunct to physical therapy and when used alone. TRIAL REGISTRATION The study protocol was registered at www. CLINICALTRIALS gov (20/05/2022, NCT05384093).
Collapse
Affiliation(s)
| | - Neil S Kumar
- Florida Orthopaedic Institute, 13020 Telecom Parkway North, Temple Terrace, Tampa, FL, 33637, USA
| | - Craig S Dent
- Foundation for Orthopaedic Research and Education, Tampa, FL, USA
| | - Spencer Neaville
- Foundation for Orthopaedic Research and Education, Tampa, FL, USA
| | - Deborah H Warren
- Foundation for Orthopaedic Research and Education, Tampa, FL, USA
| | - Peter Simon
- Foundation for Orthopaedic Research and Education, Tampa, FL, USA
- Department of Medical Engineering, College of Engineering and Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Christopher E Baker
- Florida Orthopaedic Institute, 13020 Telecom Parkway North, Temple Terrace, Tampa, FL, 33637, USA.
| |
Collapse
|
4
|
Liang CW, Cheng HY, Lee YH, De Liao C, Huang SW. Corticosteroid Injection Methods for Frozen Shoulder: A Network Meta-analysis. Arch Phys Med Rehabil 2024; 105:750-759. [PMID: 38244851 DOI: 10.1016/j.apmr.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 11/16/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVE To investigate the efficacy of corticosteroid (CS) injection methods for frozen shoulder. DATA SOURCES PubMed, Embase, and Cochrane Library were searched up to May 6, 2023. STUDY SELECTION Randomized controlled trials (RCTs) that investigated CS injection methods for frozen shoulder were included. DATA EXTRACTION Data were extracted independently by 2 authors. Risk of bias was assessed using the RoB 2 tool. DATA SYNTHESIS A random-effects network meta-analysis was performed within a frequentist framework. The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations approach. A total of 66 RCTs involving 4491 patients were included. For short-term outcomes, 4-site injection (vs placebo [PLA]: standardized mean difference [SMD]=-2.20, 95% confidence interval [CI], -2.81 to -1.59 in pain; SMD=2.02; 95% CI, 1.39-2.65 in global function) was the most effective (low certainty). Rotator interval injection was the optimal treatment with moderate to high certainty (vs PLA: SMD=-1.07, 95% CI, -1.51 to -0.64 in pain; SMD=0.94, 95% CI, 0.49-1.40 in global function). For midterm outcomes, 4-site injection was most effective (vs PLA: SMD=-1.71, 95% CI, -2.41 to -1.01 in pain; SMD=2.22, 95% CI, 1.34-3.09 in global function; low certainty). Distension via rotator interval (D-RI) was the optimal treatment with moderate to high certainty (vs PLA: SMD=-1.10, 95% CI, -1.69 to -0.51 in pain; SMD=1.46, 95% CI, 0.73-2.20 in global function). Distension and intra-articular injection via anterior or posterior approaches produced effects equivalent to those of rotator interval injection and D-RI. CONCLUSIONS Rotator interval injection, distension, and intra-articular injection had equivalent effects on symptom relief. More RCTs are required to validate the superiority of multisite injections.
Collapse
Affiliation(s)
- Chun-Wei Liang
- School of Medicine, College of Medicine, Taipei Medical University, Taipei; Department of Primary Care Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei
| | - Hsiao-Yi Cheng
- School of Medicine, College of Medicine, Taipei Medical University, Taipei; Department of Primary Care Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei
| | - Yu-Hao Lee
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Chun- De Liao
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei; Master's Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei.
| |
Collapse
|
5
|
Khoury A, Zbede N, Gannot G, Oron A. [OLECRANON BURSITIS]. Harefuah 2024; 163:249-251. [PMID: 38616636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
INTRODUCTION The olecranon bursa is a pocket-like structure located at the posterior aspect of the elbow that is responsible for the smooth movement of the surrounding tissues. Frequently, it is the source of elbow pain due to an inflammation which may be caused by local injury or penetration of bacteria through the skin. This can lead to an initial acute and possibly a late chronic inflammation. Chronic inflammation may originate from systemic diseases such as gout and rheumatoid arthritis as well. The treatment of olecranon bursitis may be conservative (non-surgical) or surgical. Recently, there is more supporting evidence for the use of conservative management over surgical intervention in treating olecranon bursitis.
Collapse
Affiliation(s)
- Ayman Khoury
- Department of Orthopedic Surgery, Unit of Hand Surgery and Microsurgery, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Nour Zbede
- Department of Orthopedic Surgery, Unit of Hand Surgery and Microsurgery, Kaplan Medical Center, Rehovot, Israel
| | - Gil Gannot
- Department of Orthopedic Surgery, Unit of Hand Surgery and Microsurgery, Kaplan Medical Center, Rehovot, Israel
| | - Amir Oron
- Department of Orthopedic Surgery, Unit of Hand Surgery and Microsurgery, Kaplan Medical Center, Rehovot, Israel
| |
Collapse
|
6
|
Lanciego C, Puentes-Gutierrez A, Sánchez-Casado M, Cifuentes-Garcia I, Fernández-Tamayo A, Dominguez-Paillacho D, Ciampi-Dopazo JJ, Marquina-Valero MA. Transarterial Embolization for Adhesive Capsulitis of the Shoulder: Midterm Outcomes on Function and Pain Relief. J Vasc Interv Radiol 2024; 35:550-557. [PMID: 38199458 DOI: 10.1016/j.jvir.2023.12.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
PURPOSE To determine the safety and potential effectiveness of transarterial embolization for adhesive capsulitis of the shoulder. MATERIALS AND METHODS This prospective study analyzed consecutive adult patients with adhesive capsulitis referred for embolization between January 2018 and May 2023 after a poor response to treatment (symptoms and limitation of motion in ≥2 axes; ≤120° flexion, ≤50° external rotation and/or internal rotation with the shoulder abducted 90°) persisting for >3 months after having completed ≥6 weeks of analgesics and physical therapy. Different types of pain and mobility were measured before embolization and 1, 3, and 6 months after embolization. Overall upper limb function (Quick Disabilities of Arm, Shoulder, and Hand) and patient satisfaction were measured before and 6 months after embolization. Long-term follow-up comprised telephone interviews and clinical history reviews. RESULTS A total of 20 patients (12 [60%] women; median age, 50.7; interquartile ranges [IQR], 45‒55 years) were included; 6 (30%) had diabetes and 15 (75%) were off work. Median duration of symptoms before embolization was 39.4 weeks (IQR, 28‒49 weeks), and median duration of rehabilitation therapy was 12.8 weeks (IQR, 8‒16 weeks). Six months after embolization, significant improvements were observed in nocturnal pain (P = .003), pain on moving (P = .001), external rotation (P < .001), internal rotation (P < .001), active flexion (P < .001), passive flexion (P = .03), active abduction (P < .001), passive abduction (P < .001), and overall function (P < .001). Despite objective improvements, patient satisfaction was nearly unchanged. Only 1 patient experienced a mild adverse event. CONCLUSION Transarterial embolization is safe and potentially effective in treating adhesive capsulitis of the shoulder refractory to conventional treatment. Clinical improvements were maintained in the mid to long term.
Collapse
Affiliation(s)
- Carlos Lanciego
- Interventional Radiology Unit, Radiology Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain.
| | - Ana Puentes-Gutierrez
- Rehabilitation and Physical Medicine Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Marcelino Sánchez-Casado
- Biostatistics Unit, Intensive Care Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Irene Cifuentes-Garcia
- Interventional Radiology Unit, Radiology Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Ana Fernández-Tamayo
- Interventional Radiology Unit, Radiology Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - David Dominguez-Paillacho
- Interventional Radiology Unit, Radiology Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Juan J Ciampi-Dopazo
- Interventional Radiology Unit, Radiology Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Maria A Marquina-Valero
- Rehabilitation and Physical Medicine Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| |
Collapse
|
7
|
Menekse S, Karatas Ö, Zora H. Impact of open bursectomy and biceps tendon release with closed manipulation in frozen shoulder. Medicine (Baltimore) 2024; 103:e37499. [PMID: 38489701 PMCID: PMC10939693 DOI: 10.1097/md.0000000000037499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 03/17/2024] Open
Abstract
This retrospective observational study evaluated the efficacy of 2 different surgical approaches for the treatment of frozen shoulder (adhesive capsulitis). This study aimed to compare the efficacy, safety, and recovery times of the 2 treatment modalities. Fifty patients diagnosed with frozen shoulder and treated at Seyhan State Hospital were included in the study. The patients were retrospectively divided into 2 groups based on the treatment received. Group 1 consisted of 25 patients who underwent standard closed manipulation under anesthesia, a technique involving passive movements of the shoulder joint to tear the tight capsule and expand the range of motion (ROM). Group 2, which included 25 patients, underwent closed manipulation in addition to open bursectomy and biceps tendon capsule release. Open bursectomy involves surgical removal of the bursa to alleviate inflammation, while biceps tendon capsule release addresses chronic biceps tendonitis by partially removing the capsule of the tendon. Data on demographic information, operative details, preoperative and postoperative conditions, and patient-reported outcomes were collected and analyzed. Data analysis revealed that the combination of closed manipulation with open bursectomy and biceps tendon capsule release was more effective in reducing pain, increasing ROM, and improving quality of life than closed manipulation alone. The discussion would typically elaborate on how the results compare with existing literature, the clinical implications, and any potential limitations of the study. The results showed that the method that combined closed manipulation with open bursectomy and biceps tendon capsule release was better than closed manipulation alone in terms of reducing pain, increasing ROM, and improving quality of life.
Collapse
Affiliation(s)
- Serdar Menekse
- Orthopedic Department, Adana Seyhan State Hospital, Seyhan, Adana, Turkey
| | - Özlem Karatas
- Physical Therapy and Rehabilitation Department, Akdeniz Universty Medicine School, Antalya, Turkey
| | - Hakan Zora
- Orthopedic Department, Special Medicabil Hospital, Bursa, Turkey
| |
Collapse
|
8
|
Jost B, Jacxsens M. [Frozen shoulder - patience during recovery]. Praxis (Bern 1994) 2024; 113:67. [PMID: 38655731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
INTRODUCTION
Collapse
Affiliation(s)
- Bernhard Jost
- Schulter- und Ellbogenchirurgie Klinik für Orthopädische Chirurgie und Traumatologie des Bewegungsapparates Kantonsspital St.Gallen Rorschacherstrasse 95 9000 St. Gallen
| | - Matthijs Jacxsens
- Schulter- und Ellbogenchirurgie Klinik für Orthopädische Chirurgie und Traumatologie des Bewegungsapparates Kantonsspital St.Gallen Rorschacherstrasse 95 9000 St. Gallen
| |
Collapse
|
9
|
Darrieutort-Laffite C, Coiffier G, Aïm F, Banal F, Bart G, Chazerain P, Couderc M, Coquerelle P, Ducourau Barbary E, Flipo RM, Faudemer M, Godot S, Hoffmann C, Lecointe T, Lormeau C, Mulleman D, Piot JM, Senneville E, Seror R, Voquer C, Vrignaud A, Guggenbuhl P, Salliot C. 2023 French recommendations for diagnosing and managing prepatellar and olecranon septic bursitis. Joint Bone Spine 2024; 91:105664. [PMID: 37995861 DOI: 10.1016/j.jbspin.2023.105664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023]
Abstract
Septic bursitis (SB) is a common condition accounting for one third of all cases of inflammatory bursitis. It is often related to professional activities. Management is heterogeneous and either ambulatory or hospital-based, with no recommendations available. This article presents recommendations for managing patients with septic bursitis gathered by 18 rheumatologists from the French Society for Rheumatology work group on bone and joint infections, 1 infectious diseases specialist, 2 orthopedic surgeons, 1 general practitioner and 1 emergency physician. This group used a literature review and expert opinions to establish 3 general principles and 11 recommendations for managing olecranon and prepatellar SB. The French Health authority (Haute Autorité de santé [HAS]) methodology was used for these recommendations. Designed for rheumatologists, general practitioners, emergency physicians and orthopedic surgeons, they focus on the use of biological tests and imaging in both outpatient and inpatient management. Antibiotic treatment options (drugs and duration) are proposed for both treatment modalities. Finally, surgical indications, non-drug treatments and prevention are covered by specific recommendations.
Collapse
Affiliation(s)
- Christelle Darrieutort-Laffite
- Rheumatology Department, CHU de Nantes, Nantes, France; Nantes Université, Oniris, CHU de Nantes, Inserm, Regenerative Medicine and Skeleton, RMeS, UMR 1229, 44000 Nantes, France
| | | | - Florence Aïm
- Orthopedic Unit and Osteoarticular Reference Center, GH Diaconesses Croix Saint-Simon, Paris, France
| | - Fréderic Banal
- Department of Rheumatology, Centre Hospitalier Universitaire Amiens Picardie, 80054 Amiens, France
| | - Géraldine Bart
- Internal Medicine and Rheumatology department, Percy Army Training Hospital, Clamart, France
| | - Pascal Chazerain
- Rheumatology Department, Groupe Hospitalier Diaconnesses Croix Saint-Simon, 75020 Paris, France
| | - Marion Couderc
- Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand, France; Inserm/Imost, UMR 1240, Clermont-Ferrand, France
| | | | | | - René-Marc Flipo
- Department of Rheumatology, CHU de Lille, Université de Lille, 59000 Lille, France
| | - Maël Faudemer
- Rheumatology Department, CHU Saint-Antoine, 75012 Paris, France
| | - Sophie Godot
- Internal Medicine and Rheumatology department, Percy Army Training Hospital, Clamart, France
| | - Céline Hoffmann
- Emergency Department, Groupe Hospitalier Diaconnesses Croix Saint-Simon, 75020 Paris, France
| | - Thibaut Lecointe
- Orthopedic surgery Department, CHU d'Orléans, Orléans University, 45067 Orléans, France
| | | | - Denis Mulleman
- EA6295 Nano Medicines & Nano Probes Research Group, University of Tours, Department of Rheumatology, CHRU de Tours, Tours, France
| | - Jean-Maxime Piot
- Rheumatology Department, Centre Hospitalier du Mans, Le Mans, France
| | - Eric Senneville
- Department of Infectious Diseases, Tourcoing Hospital, Tourcoing, France
| | - Raphaèle Seror
- Rheumatology Department, AP-HP, Hôpitaux Universitaires Paris-Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; Centre of Immunology of Viral Infections and Autoimmune Diseases (IMVA), Inserm U1184, Université Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | | | | | - Pascal Guggenbuhl
- Rheumatology Department, Hôpital Sud, CHU de Rennes, 35000 Rennes, France; Rennes University, Inserm, CHU de Rennes, Institut NUMECAN (Nutrition Metabolisms and Cancer), UMR 1317, 35000 Rennes, France
| | - Carine Salliot
- Rheumatology Department, CHU d'Orléans, Orléans University, 45067 Orléans, France.
| |
Collapse
|
10
|
Windischbauer D, Eid K. [Frozen Shoulder - a short review for the practice]. Praxis (Bern 1994) 2024; 113:68-73. [PMID: 38655732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
INTRODUCTION The Frozen Shoulder is a frequently encountered pathology in clinical practice. This condition often coexists with various comorbidities and is characterized by severe pain and a significantly restricted motion of the affected shoulder. A limited passive external rotation with the arm in adduction, with no signs of any other pathology that could explain the finding, such as shoulder osteoarthritis or an undetected posterior dislocation, is pathognomonic. The course of the disease typically spans over one to two years and is usually self-limiting. In the vast majority of cases, this condition can be managed conservatively. Keywords: shoulder, shoulder stiffness, shoulder pain, conservative therapy.
Collapse
Affiliation(s)
| | - Karim Eid
- Kantonsspital Baden Im Ergel 1 5404 Baden
| |
Collapse
|
11
|
Foxcroft B, Stephens G, Woodhead T, Ayre C. What factors influence pain scores following Corticosteroid injection in patients with Greater Trochanteric Pain Syndrome? A systematic review. BMC Musculoskelet Disord 2024; 25:149. [PMID: 38365672 PMCID: PMC10874005 DOI: 10.1186/s12891-024-07217-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/20/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Cortico-Steroid Injections (CSI) are commonly used to treat patients with Greater Trochanteric Pain Syndrome (GTPS) but it is unclear which patients will experience improvements in pain. OBJECTIVES To identify factors that influence improvements in pain for patients with GTPS treated with CSI. DESIGN Systematic review. METHODS A search was undertaken of AMED, CINAHL, Cochrane Library, EMBASE, Medline and PEDro databases. Studies were eligible for inclusion if they investigated factors that influenced changes in pain experienced by patients with GTPS who received a CSI. Studies needed to include relevant summary statistics and tests of clinical significance. Risk Of Bias in Non-randomised Trials Of Interventions (ROBINS-I) and Risk Of Bias 2 (ROB2) tools were used to assess bias. RESULTS The search identified 466 studies, 8 were included in the final review with a total of 643 participants. There was no association between demographic variables such as age, sex, symptom duration or obesity and pain outcomes post-CSI. Having a co-existing musculoskeletal (MSK) condition such as knee osteoarthritis or sacroiliac/lumbar spine pain was associated with less pain reduction post-CSI. Injections into the Trochanteric Bursa were associated with longer lasting pain reduction than Gluteus Medius Bursa or extra-bursal injections. Image guidance of CSI maintained lower pain scores at six months but did not increase the duration of the therapeutic effect past six months. The presence of specific ultrasound scan features was not associated with differences in pain scores. CONCLUSIONS Patients with co-existing MSK conditions may not respond to CSI as well as those without. Injections into the Greater Trochanteric Bursa may have longer lasting benefit. Further research is needed on the use of USS imaging findings and image guidance.
Collapse
Affiliation(s)
- Ben Foxcroft
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, The University of Leeds, Leeds, UK.
- Leeds Community Healthcare NHS Trust, Leeds, UK.
| | - Gareth Stephens
- The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | | | - Colin Ayre
- The University of Bradford, Bradford, UK
- Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, UK
| |
Collapse
|
12
|
Wu SY, Hsu PC, Tsai YY, Huang JR, Wang KA, Wang JC. Efficacy of combined ultrasound-guided hydrodilatation with hyaluronic acid and physical therapy in patients with adhesive capsulitis: A randomised controlled trial. Clin Rehabil 2024; 38:202-215. [PMID: 37697666 DOI: 10.1177/02692155231200089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
OBJECTIVE To evaluate the therapeutic effect of combining ultrasound-guided hydrodilatation with hyaluronic acid and physical therapy compared with physical therapy alone in patients with adhesive capsulitis. DESIGN A prospective, single-blinded, randomised controlled trial. SETTING Single medical centre. PARTICIPANTS Patients with adhesive capsulitis (N = 62) were divided into group A: ultrasound-guided hydrodilatation with hyaluronic acid + physical therapy (N = 31) and group B: physical therapy alone (N = 31). INTERVENTIONS Group A received three doses of ultrasound-guided hydrodilatation with hyaluronic acid-based injectates (20 mL in total). Both groups underwent structured physical therapy. OUTCOME MEASURES The primary outcome measure was Constant score, while secondary outcomes included Shoulder Pain and Disability Index score, numerical rating scale (at rest, night, and during motion), 36-item Short Form Health Survey, and range of motion of the shoulder. All measurements were collected at baseline, 6 weeks, and 12 weeks post-injection. RESULTS At week 12, the Constant scores were 68.29 ± 14.55 and 62.77 ± 14.44 for groups A and B, respectively. There was a greater reduction in the Constant score, Shoulder Pain and Disability Index, and numerical rating scale between the baseline and 6 weeks and between the baseline and 12 weeks in group A (Constant score: p < 0.05, Shoulder Pain and Disability Index: p < 0.01, and numerical rating scale: p < 0.05). CONCLUSION The combination of ultrasound-guided hydrodilatation with hyaluronic acid in conjunction with physical therapy provides additional benefits compared to physical therapy alone for the treatment of adhesive capsulitis at up to 12 weeks. TRIAL REGISTRATION ClinicalTrials.gov: NCT02708706.
Collapse
Affiliation(s)
- Shang-Yu Wu
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Cheng Hsu
- Department of Physical Medicine and Rehabilitation, West Garden Hospital, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation Medicine, National Taiwan University Hospital Beihu Branch, Taipei, Taiwan
| | - Yuan-Yuan Tsai
- Department of Physical Medicine and Rehabilitation Medicine, National Taiwan University Hospital Beihu Branch, Taipei, Taiwan
| | - Jian-Ru Huang
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kevin A Wang
- Divison of General Surgery, Department of Surgery, Shin-Kong Memorial Hospital, Taipei, Taiwan
- School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Jia-Chi Wang
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| |
Collapse
|
13
|
Kuhn I, Erber B, Goller SS. [Adhesive capsulitis]. Radiologie (Heidelb) 2024; 64:119-124. [PMID: 37801107 DOI: 10.1007/s00117-023-01217-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Adhesive capsulitis (CA; also called Frozen shoulder) is a common, usually unilateral disease of the shoulder joint primarily affecting middle-aged women. Primary, idiopathic, and secondary forms are distinguished. Painful active and passive movement restriction are the clinically leading symptoms. COURSE OF THE DISEASE The disease usually progresses in three successive stages: freezing phase, frozen phase, and thawing phase. CLINICAL DIAGNOSIS AND IMAGING CA is primarily diagnosed clinically, with imaging being used to assess or exclude differential diagnoses. Radiography as part of basic diagnostics allows exclusion of common differential diagnoses such as osteoarthritis of the shoulder or calcific tendinitis. Native magnetic resonance imaging (MRI) and MR arthrography (MRA) reveal pathomorphologies typical of CA. Intravenously administered gadolinium increases the sensitivity of MRI. Sonography may be used as a complementary diagnostic modality or as an alternative in case of contraindications to MRI. Fluoroscopy-guided arthrography has been replaced by MRI because of its invasiveness. Computed tomography (CT) has no role in diagnostics due to its radiation exposure and significantly lower sensitivity and specificity compared to MRI. TREATMENT Therapy of CA is stage-adapted and includes conservative measures such as analgesics and physiotherapy and surgical procedures such as arthroscopic arthrolysis. The therapeutic spectrum is supplemented by new, innovative procedures such as transarterial periarticular embolization. PROGNOSIS CA is self-limiting and usually persists for 2-3 years. However, the patients may even suffer from pain and limited range of motion beyond this time.
Collapse
Affiliation(s)
- Isabella Kuhn
- Muskuloskelettales Universitätszentrum München (MUM), LMU Klinikum, Ziemssenstr. 5, 80336, München, Deutschland
| | - Bernd Erber
- Klinik und Poliklinik für Radiologie, LMU Klinikum, LMU München, Marchioninistr. 15, 81377, München, Deutschland
| | - Sophia Samira Goller
- Klinik und Poliklinik für Radiologie, LMU Klinikum, LMU München, Marchioninistr. 15, 81377, München, Deutschland.
- Radiologie, Universitätsklinik Balgrist, Forchstr. 340, 8008, Zürich, Schweiz.
| |
Collapse
|
14
|
Staruch M, Gomez S, Rogers S, Takacs I, Kern T, Adler S, Cadosch D, Riesterer O. Low-dose radiotherapy for greater trochanteric pain syndrome-a single-centre analysis. Strahlenther Onkol 2024; 200:128-133. [PMID: 37580573 PMCID: PMC10805988 DOI: 10.1007/s00066-023-02107-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/04/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE To determine predictive factors associated with a good response (GR) to and efficacy of low-dose radiotherapy (LDRT) in patients with greater trochanteric pain syndrome (GTPS). METHODS Patients with GTPS were irradiated on a linear accelerator with 0.5-1.0 Gy per fraction to a total dose of 3.0-4.0 Gy per series. The endpoint was subjective good response (GR) to treatment 2 months after completion of the last LDRT series, defined as complete pain relief or marked improvement assessed using the von Pannewitz score. A positive response to steroid injection (SI) was defined as pain relief of at least 7 days. Patient and treatment-related characteristics were evaluated with respect to LDRT outcomes. RESULTS Outcomes were assessed for 71 peritrochanteric spaces (PTSs; 65 patients, 48 females, with mean age of 63 [44-91] years). Prior SI had been given to 55 (77%) PTSs and 40 PTSs received two series of LDRT. Two months after completion of LDRT, GR was reported in 42 PTSs (59%). Two series of LDRT provided a significantly higher rate of GR than one series (72.5 vs. 42% PTSs, p = 0.015). Temporary pain relief after prior SI predicted GR to LDRT compared with PTSs which had not responded to SI (73 vs. 28% PTSs, p = 0.001). A regional structural abnormality, present in 34 PTSs (48%), was associated with a reduction of GR to LDRT (44 vs. 73% PTSs, p = 0.017). CONCLUSION LDRT is an effective treatment for GTPS. Administration of two LDRT series, prior response to SI, and absence of structural abnormalities may predict significantly better treatment outcomes.
Collapse
Affiliation(s)
- Michal Staruch
- Center for Radiation Oncology KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland.
- Clinical Trial Unit, Department of Clinical Research, University Hospital of Basel, University of Basel, 4031, Basel, Switzerland.
- University of Bern, Hochschulstrasse 6, 3012, Bern, Switzerland.
| | - Silvia Gomez
- Center for Radiation Oncology KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - Susanne Rogers
- Center for Radiation Oncology KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - Istvan Takacs
- Center for Radiation Oncology KSA-KSB, Kantonsspital Baden, 5404, Baden, Switzerland
| | - Thomas Kern
- Center for Radiation Oncology KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - Sabine Adler
- Department of Rheumatology, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - Dieter Cadosch
- Department of Orthopaedic and Traumatology, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - Oliver Riesterer
- Center for Radiation Oncology KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland
| |
Collapse
|
15
|
Pimenta M, Vassalou EE, Klontzas ME, Dimitri-Pinheiro S, Ramos I, Karantanas AH. Ultrasound-guided hydrodilatation for adhesive capsulitis: capsule-preserving versus capsule-rupturing technique. Skeletal Radiol 2024; 53:253-261. [PMID: 37400605 PMCID: PMC10730627 DOI: 10.1007/s00256-023-04392-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/17/2023] [Accepted: 06/18/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE To compare the clinical efficacy of capsule-rupturing versus capsule-preserving ultrasound-guided hydrodilatation in patients with shoulder adhesive capsulitis (AC). To determine potential factors affecting the outcome over a 6-month follow-up. MATERIALS AND METHODS Within a 2-year period, 149 consecutive patients with AC were prospectively enrolled and allocated into (i) group-CR, including 39 patients receiving hydrodilatation of the glenohumeral joint (GHJ) with capsular rupture and (ii) group-CP, including 110 patients treated with GHJ hydrodilatation with capsular preservation. Demographics, affected shoulder, and AC grade were recorded. Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and visual analog scale (VAS) were used for clinical assessment at baseline/1/3/6 months. Comparisons were performed with Mann-Whitney U test and Kolmogorov-Smirnov test. Linear regression was used to identify predictors of outcome. P value < 0.05 defined significance. RESULTS DASH and VAS scores in both groups improved significantly compared to baseline (P < 0.001) and were significantly lower in the CP compared to CR group at all time-points following intervention (P < 0.001). Capsule rupture was a significant predictor of DASH score at all time-points (P < 0.001). DASH scores correlated to initial DASH score at all time-points (P < 0.001). DASH/VAS scores at 1 month were correlated to the AC grade (P = 0.025/0.02). CONCLUSION GHJ hydrodilatation results in pain elimination and functional improvement till the mid-term in patients with AC, with improved outcome when adopting the capsule-preserving compared to the capsule-rupturing technique. Higher initial DASH score is predictive of impaired functionality in the mid-term.
Collapse
Affiliation(s)
- Madalena Pimenta
- Oporto Armed Forced Hospital, University Clinical Center D. Pedro V, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Evangelia E Vassalou
- Department of Medical Imaging, University Hospital of Heraklion, Voutes, 71110, Crete, Greece
| | - Michail E Klontzas
- Department of Medical Imaging, University Hospital of Heraklion, Voutes, 71110, Crete, Greece
- Department of Radiology, School of Medicine, University of Crete, Voutes Campus, 71110, Heraklion, Greece
| | - Sofia Dimitri-Pinheiro
- Faculty of Medicine, University of Porto, Porto, Portugal
- Biomedicine Department, Unit of Biochemistry, Faculty of Medicine, University of Porto, Porto, Portugal
- Radiology Department, Portuguese Institute of Oncology of Porto - Francisco Gentil EPE, Porto, Portugal
| | - Isabel Ramos
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Apostolos H Karantanas
- Department of Medical Imaging, University Hospital of Heraklion, Voutes, 71110, Crete, Greece.
- Department of Radiology, School of Medicine, University of Crete, Voutes Campus, 71110, Heraklion, Greece.
| |
Collapse
|
16
|
Martens G, Fontaine R, Goffin P, Raaf M, Tasset H, Lecoq JP, Benmouna K, Kaux JF, Forthomme B. Continuous suprascapular nerve blockade to potentiate intensive rehabilitation for refractory adhesive shoulder capsulitis: a cohort study. Int Orthop 2024; 48:495-503. [PMID: 37848767 DOI: 10.1007/s00264-023-05999-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/25/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE Evaluating the short- and long-term efficacy of a continuous ten day suprascapular nerve block combined with daily multidisciplinary rehabilitation on shoulder range of motion (ROM), pain, and function in patients with refractory adhesive capsulitis (AC). METHODS In this retrospective cohort study, patients admitted to a specialized pain clinic for refractory AC for more than 6 months underwent continuous suprascapular nerve blockade for ten days and received 2 hours of physiotherapy and occupational therapy daily. Standardized assessments were performed at baseline, at days three, six, ten, 30, 90, and 180, and included active and passive ROM measurements, the visual analog scale (VAS) for pain and the disabilities of the arm, shoulder and hand (DASH) questionnaire to assess pain, disability, and quality of life. Improvements over time were assessed using ANOVAs. RESULTS Thirty-two patients were followed (age: 52 ± 8 years, 25 females, mean symptoms duration of two years). There was a significant improvement in ROM for all amplitudes at day ten (short-term; range: 20-35°, p < 0.001) and at day 180 (long-term; range: 18-47°, p < 0.001). The pain and disability scores significantly reduced by day 180 (mean VAS reduction: 2.6 units, p < 0.001; mean DASH reduction: 9.5 points, p < 0.001). CONCLUSION Continuous SSNB combined with intensive multidisciplinary rehabilitation represents an efficient therapeutic option for patients with chronic AC who did not respond to conventional treatments.
Collapse
Affiliation(s)
- Géraldine Martens
- Department of Physical Medicine and Sports Traumatology, SportS², FIFA Medical Centre of Excellence, IOC Research Centre for Prevention of Injury and Protection of Athlete Health, FIMS Collaborative Center of Sports Medicine, University and University Hospital of Liège, Liège, Belgium.
- Department of Rehabilitation and Sports Sciences, University of Liège, Liège, Belgium.
| | - Robert Fontaine
- Anesthesia & Intensive Care Department, University Hospital of Liège, Liège, Belgium
| | - Pierre Goffin
- Anesthesia & Intensive Care Department, MontLegia Hospital, Groupe Santé CHC, Liège, Belgium
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Mélissa Raaf
- Anesthesia & Intensive Care Department, University Hospital of Liège, Liège, Belgium
- Anesthesia & Intensive Care Department, MontLegia Hospital, Groupe Santé CHC, Liège, Belgium
| | - Hadrien Tasset
- Anesthesia & Intensive Care Department, University Hospital of Liège, Liège, Belgium
| | - Jean-Pierre Lecoq
- Anesthesia & Intensive Care Department, University Hospital of Liège, Liège, Belgium
| | - Karim Benmouna
- Department of Physical Medicine and Sports Traumatology, SportS², FIFA Medical Centre of Excellence, IOC Research Centre for Prevention of Injury and Protection of Athlete Health, FIMS Collaborative Center of Sports Medicine, University and University Hospital of Liège, Liège, Belgium
| | - Jean-François Kaux
- Department of Physical Medicine and Sports Traumatology, SportS², FIFA Medical Centre of Excellence, IOC Research Centre for Prevention of Injury and Protection of Athlete Health, FIMS Collaborative Center of Sports Medicine, University and University Hospital of Liège, Liège, Belgium
- Department of Rehabilitation and Sports Sciences, University of Liège, Liège, Belgium
| | - Bénédicte Forthomme
- Department of Physical Medicine and Sports Traumatology, SportS², FIFA Medical Centre of Excellence, IOC Research Centre for Prevention of Injury and Protection of Athlete Health, FIMS Collaborative Center of Sports Medicine, University and University Hospital of Liège, Liège, Belgium
- Department of Rehabilitation and Sports Sciences, University of Liège, Liège, Belgium
| |
Collapse
|
17
|
Qiao Y, Wang J, Zheng L, Yang Y, Li H, Li M, Zhang S, Wang H, Zhang T. Proteomics and phosphoproteomics to study Tuina reverses capsule fibrosis in frozen shoulder: a research report based on rats. Sci Rep 2024; 14:661. [PMID: 38182704 PMCID: PMC10770356 DOI: 10.1038/s41598-023-50904-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024] Open
Abstract
Frozen shoulder (FS) is a common disorder often treated with Tuina, but the mechanisms involved remain unclear. We employed proteomics and phosphoproteomics to investigate the mechanisms associated with the treatment of capsule fibrosis in FS rats. We used a method composed of three weeks of cast immobilization to establish a model of FS. We then administered Tuina once daily for 14 days, evaluated glenohumeral range of motion (ROM), assessed histological changes, and identified differentially expressed proteins (DEPs) using proteomics and phosphoproteomics. This study demonstrated that Tuina could improve glenohumeral ROM and reserve capsule fibrosis in FS rats. Proteomics revealed proteins regulated by Tuina belonging to the PI3K-AKT and ECM receptor interaction signaling pathways. Phosphoproteomics detected differentially phosphorylated proteins regulated by Tuina to be enriched in the MAPK signaling pathway. The combination of proteomics and phosphoproteomics for Protein-Protein Interaction (PPI) network analysis revealed that the phosphorylation of Myh3 and Srsf1 with a node degree larger than the average degree were considered the central regulatory protein modulated by Tuina to reverse capsule fibrosis. Thbs1, Vtn, and Tenascin-W were significantly enriched in PI3K-AKT and ECM receptor interaction signaling pathways and highly expressed in model rats. Tuina resulted in reduced expression of these proteins. Our findings demonstrated some of mechanisms behind the reversal of FS capsule fibrosis following Tuina, a scientific medical therapy for FS patients.
Collapse
Affiliation(s)
- Yingjie Qiao
- College of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jianmin Wang
- Department of Tuina, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, Shandong, China
| | - Lijun Zheng
- College of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yanhong Yang
- Special Education and Rehabilitation College, Binzhou Medical University, Binzhou, Shandong, China
| | - Huadong Li
- Department of Tuina, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, Shandong, China.
| | - Muzhen Li
- College of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Shidong Zhang
- College of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Hongyi Wang
- College of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Tiantian Zhang
- College of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| |
Collapse
|
18
|
Fortier LM, Smith KL, Ina JG, Sinkler MA, Calcei JG, Salata MJ, Gillespie R, Voos JE. Common characteristics of shoulder injury related to vaccine administration following COVID-19 vaccination: a comprehensive systematic review. J Shoulder Elbow Surg 2024; 33:202-209. [PMID: 37660886 DOI: 10.1016/j.jse.2023.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/18/2023] [Accepted: 07/29/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND The pathogenesis of shoulder injury related to vaccine administration (SIRVA) is incompletely understood, but it is postulated to be an immune-mediated inflammatory response to a vaccine antigen, leading to shoulder pain and dysfunction. The purpose of this investigation is to systematically review the literature related to SIRVA specifically after the COVID-19 vaccination by describing the diagnostic and clinical characteristics, diagnoses associated with SIRVA, and incidence between vaccine types. METHODS A systematic review was performed to identify level I to IV studies and case descriptions of shoulder pain occurring after COVID-19 vaccination. To confirm that no studies were missing from the systematic review, references of studies from the initial search were scanned for additional relevant studies. RESULTS A total of 22 studies, comprised of 81 patients, were identified meeting the inclusion/exclusion criteria. Reports were most commonly published from countries in Asia (53.1%; n = 43/81). The most commonly described vaccines were Oxford-AstraZeneca at 37.0% (n = 30/81) and Pfizer-BioNTech at 33.3% (n = 27/81). Symptoms occurred most commonly after at least 72 hours of administration (30.9%, n = 25/81). One hundred percent of patients (n = 81/81) described pain as an associated symptom and 90.1% of patients (n = 73/81) described multiple symptoms. The diagnostic modalities utilized to identify a specific pathology consisted of magnetic resonance imaging (55.6%; n = 45/81), ultrasound (28.4; n = 23/81), radiograph (25.9%; n = 21/81), and computed tomography (4.9%; 4/81). Nearly a third of patients (32.1%; n = 26/81) were diagnosed with bursitis, while 22 (27.2%) were diagnosed with adhesive capsulitis, 17 (21.0%) with either rotator cuff tear or tendinopathy, and 14 (17.3%) with polymyalgia rheumatica or polymyalgia rheumatica-like syndrome. The 2 most common treatment options were physical therapy (34.6%; n = 28/81) and nonsteroidal anti-inflammatory medications (33.3%; 27/81). The majority of SIRVA cases (52.1%; n = 38/73) completely resolved within a few weeks to months. CONCLUSION Despite the limited quality and lack of large-scale studies, it is important for providers to recognize SIRVA as a potential risk factor as the number of patients receiving COVID-19 vaccinations and boosters continues to rise.
Collapse
Affiliation(s)
- Luc M Fortier
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
| | - Kira L Smith
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Jason G Ina
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Margaret A Sinkler
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Jacob G Calcei
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Michael J Salata
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Robert Gillespie
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - James E Voos
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| |
Collapse
|
19
|
Musa A, Miller S, Amado AA, Abbas M, Kayder OO, Newberger S, Harb A. ACE in the Hole: Adhesive Capsulitis Embolization for the Treatment of Frozen Shoulder. Cardiovasc Intervent Radiol 2024; 47:146-147. [PMID: 38082021 DOI: 10.1007/s00270-023-03622-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Arif Musa
- Department of Radiology, Detroit Receiving Hospital, Detroit Medical Center, Wayne State University School of Medicine, 4201 St. Antoine Street, Detroit, MI, 48201, USA.
| | - Stephan Miller
- Department of Radiology, Detroit Receiving Hospital, Detroit Medical Center, Wayne State University School of Medicine, 4201 St. Antoine Street, Detroit, MI, 48201, USA
| | - Adam A Amado
- Department of Radiology, Detroit Receiving Hospital, Detroit Medical Center, Wayne State University School of Medicine, 4201 St. Antoine Street, Detroit, MI, 48201, USA
| | - Mahmoud Abbas
- Department of Radiology, Detroit Receiving Hospital, Detroit Medical Center, Wayne State University School of Medicine, 4201 St. Antoine Street, Detroit, MI, 48201, USA
| | - Orest O Kayder
- Department of Radiology, Detroit Receiving Hospital, Detroit Medical Center, Wayne State University School of Medicine, 4201 St. Antoine Street, Detroit, MI, 48201, USA
| | - Shane Newberger
- Department of Radiology, Detroit Receiving Hospital, Detroit Medical Center, Wayne State University School of Medicine, 4201 St. Antoine Street, Detroit, MI, 48201, USA
| | - Ali Harb
- Department of Radiology, Detroit Receiving Hospital, Detroit Medical Center, Wayne State University School of Medicine, 4201 St. Antoine Street, Detroit, MI, 48201, USA
| |
Collapse
|
20
|
Brindisino F, Minnucci S, Sergi G, Lorusso M, Struyf F, Innocenti T. Does the psychological profile of a patient with frozen shoulder predict future outcome? A systematic review. Physiother Res Int 2024; 29:e2056. [PMID: 37867399 DOI: 10.1002/pri.2056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND AND PURPOSE Frozen shoulder (FS) is defined as a condition characterised by functional restriction and daily and nightly pain. As in other shoulder pathologies, the manifestation of psychological factors is recognised in FS; however, from a psychological point of view, only few studies have reported its prognostic value. The aim of this systematic review is to investigate, in patients with FS, the prognostic value of psychological factors on pain, function, disability, health-related quality of life, return to work and time to recovery. MATERIALS AND METHODS This systematic review was reported following the Preferred Reporting Items for Systematic reviews and Meta-Analysis-PRISMA 2020 guideline. The authors followed the Cochrane Handbook for Systematic review of Intervention as methodological guidance. The Quality in Prognostic Studies-QUIPS tool was used to assess the risk of bias. RESULTS Pain-related fear and depression could be prognostic regarding patient-reported outcome measures assessing shoulder function, disability, and pain; instead, pain catastrophizing could have a prognostic value assessed by the disability of the arm shoulder and hand -DASH scale. Anxiety would appear to impact on disability and pain. DISCUSSION AND CONCLUSIONS As widely reported in numerous musculoskeletal conditions, also in FS psychological factors influence the physical dimension such as pain, disability and function. Therefore, clinicians should be encouraged to identify these factors through a comprehensive assessment of the bio-psychological profile of each individual with FS. Perhaps, patients with FS that show such psychological prognostic factors could benefit from a comprehensive and shared approach with other dedicated professionals.
Collapse
Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, Campobasso, Italy
| | - Silvia Minnucci
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata" c/o Medicine and Surgery School, Rome, Italy
| | | | - Mariangela Lorusso
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata" c/o Medicine and Surgery School, Rome, Italy
| | - Filip Struyf
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Tiziano Innocenti
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- GIMBE Foundation, Bologna, Italy
| |
Collapse
|
21
|
Rusanov A, Vitomskyi V, Roi I, Borzykh N, Kudrin A. Dynamics of disability and pain indicators under the influence of physical therapy for adhesives capsulitis and myofascial pain syndrome. Wiad Lek 2024; 77:55-61. [PMID: 38431808 DOI: 10.36740/wlek202401108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
OBJECTIVE Aim: To compare the effectiveness of end-range mobilization and therapeutic exercises, used in combination with ischemic compression, on disability and pain indicators among patients with adhesive capsulitis of the shoulder joint and thoracic myofascial pain syndrome. PATIENTS AND METHODS Materials and Methods: The study involved 68 patients. Goniometry of the shoulder joint, assessment of pain in myofascial trigger points, and the Shoulder Pain and Disability Index questionnaire were used before and after physical therapy. The duration of physical therapy comprised 3 weeks. Physical therapy of the first group of patients consisted of end-range mobilization and ischemic compression. Patients of the second group performed therapeutic exercises and ischemic compression. RESULTS Results: Both groups demonstrated positive dynamics of shoulder joint mobility, Shoulder Pain and Disability Index and pain in trigger points. However, the final results of the studied indicators were better in the first group of patients. CONCLUSION Conclusions: Physical therapy based on the combination of end-range mobilization and ischemic compression had a more positive impact on disability and pain indicators for adhesive capsulitis of the shoulder joint and myofascial pain syndrome as compared to the combination of therapeutic exercises and ischemic compression.
Collapse
Affiliation(s)
- Andrii Rusanov
- NATIONAL UNIVERSITY OF UKRAINE ON PHYSICAL EDUCATION AND SPORT, KYIV, UKRAINE; GI ≪INSTITUTE OF TRAUMATOLOGY AND ORTHOPEDICS OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE≫, KYIV, UKRAINE
| | - Volodymyr Vitomskyi
- NATIONAL UNIVERSITY OF UKRAINE ON PHYSICAL EDUCATION AND SPORT, KYIV, UKRAINE
| | - Iryna Roi
- GI ≪INSTITUTE OF TRAUMATOLOGY AND ORTHOPEDICS OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE≫, KYIV, UKRAINE
| | - Natalia Borzykh
- GI ≪INSTITUTE OF TRAUMATOLOGY AND ORTHOPEDICS OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE≫, KYIV, UKRAINE
| | - Anton Kudrin
- GI ≪INSTITUTE OF TRAUMATOLOGY AND ORTHOPEDICS OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE≫, KYIV, UKRAINE
| |
Collapse
|
22
|
Webb CW, McLeod G, Nuti R. Injections of the Hip and Knee. Am Fam Physician 2024; 109:61-70. [PMID: 38227872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Hip and knee injections are useful diagnostic and therapeutic tools for family physicians. This article reviews anatomic landmark-guided and ultrasound-guided injections and aspiration techniques for greater trochanteric pain syndrome, the hip joint, the knee joint, the pes anserine bursa, and the iliotibial band. Indications for injections include acute and chronic inflammatory conditions, such as rheumatoid arthritis; osteoarthritis; overuse; and traumas. Joint aspirations may be performed to aid in the diagnosis of unexplained effusions and to relieve pain. Technique, injectant, and follow-up timing depend on the physician's comfort, experience, and preference. Infections of the skin or soft tissue are the primary contraindications to injections. The most common complications are local inflammatory reactions to the injectant. These reactions usually cause soreness for 24 to 48 hours, then spontaneously resolve. Follow-up after injections is usually scheduled within two to six weeks.
Collapse
Affiliation(s)
- Charles W Webb
- Louisiana State University Health Shreveport School of Medicine, Shreveport, Louisiana
| | - Geoff McLeod
- The Citadel, Charleston, South Carolina; Medical University of South Carolina, Charleston, South Carolina
| | | |
Collapse
|
23
|
Zhou K, Xie X, Liu J, Tao J, Liu Q, Zhou N, Zhou W, Tao Y, Chen Y. One-time relieving of frozen shoulder motor dysfunction with pure acupotomy: A case report. Medicine (Baltimore) 2023; 102:e36783. [PMID: 38206707 PMCID: PMC10754542 DOI: 10.1097/md.0000000000036783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 10/13/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Frozen shoulder (FS) is characterized by shoulder pain and restricted movement of the shoulder joint. While it tends to resolve on its own, it significantly affects an individual quality of daily life. The pure acupotomy technique employs needle-knife manipulation as the sole treatment, without the use of medications, such as steroids or vitamins, and local anesthesia if necessary. It aims to restore soft tissue mechanical balance and circulation through techniques such as cutting and stripping, creating a "gap effect." This technique can rapidly, safely, and effectively relieve functional impairments in patients with FS. This article presents a case study of the successful treatment of FS using a purely needle-knife technique. PATIENT CONCERNS The patient, aged 57 years, presented with chronic pain in the right shoulder, which was particularly aggravated at night, and moderate limitations in joint mobility. DIAGNOSES The patient was diagnosed with periarthritis of the right shoulder (moderate FS, frozen period), type 2 diabetes, and supraspinatus tendinitis of the right shoulder. INTERVENTIONS Conventional treatments, such as topical analgesics and acupuncture, produced insignificant improvements in symptoms. So, the patient chose acupotomy treatment and signed the treatment consent form. OUTCOMES After undergoing one minimally invasive acupotomy treatment, the patient experienced immediate restoration of normal shoulder joint mobility and a significant reduction in pain intensity 3 days post-treatment. LESSONS We believe that utilizing a purely acupotomy treatment for passive functional impairments in FS not only yields good results but also saves patients time and reduces their financial burden. This is worth promoting extensively in clinical practice.
Collapse
Affiliation(s)
- Kangyan Zhou
- Chengdu University of Traditional Chinese Medicine, Sichuan, China
| | - Xiaolin Xie
- Zhongxian Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Jie Liu
- Zhongxian Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Jing Tao
- Zhongxian Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Qiong Liu
- Zhongxian Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Nan Zhou
- Zhongxian Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Wenchao Zhou
- Zhongxian Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Yinli Tao
- Zhongxian Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Yongliang Chen
- Zhongxian Hospital of Traditional Chinese Medicine, Chongqing, China
| |
Collapse
|
24
|
Biglia A, Morandi V, Zanframundo G, Donati D, Maggiore F, Vita F, Sammarchi L, Pagani C, Cavagna L, Galletti S, Montecucco C. Adhesive capsulitis after COVID-19 vaccine injection: a peculiar case treated with combined bursa distention and glenohumeral capsular hydrodilatation. J Ultrasound 2023; 26:909-911. [PMID: 36595199 PMCID: PMC9809505 DOI: 10.1007/s40477-022-00739-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 10/01/2022] [Indexed: 01/04/2023] Open
Abstract
Frozen shoulder is a common and self-limiting condition affecting the soft tissues of the shoulders, characterized by severe pain, impaired range of motion (ROM) and limitation of daily activities. Its prevalence is 5% and it occurs most commonly in the fifth and sixth decades of life; women are more affected [DePalma in Clin Orthop Relat Res 466:552-560, 2008]. It can be idiopathic or associated with other conditions such as metabolic disorders, diabetes, thyroid diseases, prolonged immobilization, trauma [DePalma in Clin Orthop Relat Res 466:552-560, 2008], or complications after vaccine administration known as SIRVA (Shoulder injury related to vaccine administration). SIRVA is not caused by the vaccine itself but by inappropriate vaccination techniques [Martín Arias et al. in Vaccine 35:4870-4876, 2017]. The natural history of the frozen shoulder is a progression through three stages based on clinical and arthroscopic presentations: freezing, frozen and thawing [DePalma in Clin Orthop Relat Res 466:552-560, 2008; Do et al. in Orthop J Sport Med 9:232596712110036, 2021]. The onset is characterized by disabling pain, that worsens at night; it is induced by inflammation and hypervascularity and lasts from 10 to 36 weeks [Do et al. in Orthop J Sport Med 9:232596712110036, 2021]. The second stage is predominated by stiffness and severe reduction of ROM. This phase typically lasts from 9 to 12 months [Do et al. in Orthop J Sport Med 9:232596712110036, 2021]. Eventually, a recovery phase occurs, with a gradual recovery of the ROM that can last between 12 and 42 months. Ultrasound is an emerging diagnostic tool that contributes to differential diagnosis and treatment [Zappia et al. in Insights Imaging 7:365-371, 2016; Ricci et al. in J Ultrasound Med 39:633-635, 2020]: signs of adhesive capsulitis consist of thickening of the inferior recess of the glenohumeral joint capsule, thickening of the coracohumeral ligament and soft tissue structures in the rotator cuff interval, with hypervascularity. An unspecific sign is increased fluid in the tendon sheath of the long head of the biceps [Martín Arias et al. in Vaccine 35:4870-4876, 2017; Tandon et al. in J Ultrasound 20:227-236, 2017].
Collapse
Affiliation(s)
- Alessandro Biglia
- Department of Internal Medicine and Therapeutics, Università di Pavia, Pavia, Italy
- Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, V. le Golgi 19, 27100, Pavia, Italy
| | - Valentina Morandi
- Department of Internal Medicine and Therapeutics, Università di Pavia, Pavia, Italy.
- Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, V. le Golgi 19, 27100, Pavia, Italy.
| | - Giovanni Zanframundo
- Department of Internal Medicine and Therapeutics, Università di Pavia, Pavia, Italy
- Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, V. le Golgi 19, 27100, Pavia, Italy
| | - Danilo Donati
- Physical Medicine and Rehabilitation Unit, IRCCS-Istituto Ortopedico Rizzoli, Bologna, BO, Italy
| | - Francesco Maggiore
- Department of Internal Medicine and Therapeutics, Università di Pavia, Pavia, Italy
- Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, V. le Golgi 19, 27100, Pavia, Italy
| | - Fabio Vita
- Department of Orthopedic and Traumatological Surgery, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Luigi Sammarchi
- Department of Diagnostic and Interventional Radiology and Neuroradiology, IRCCS San Matteo University Hospital Foundation, Pavia, Italy
| | - Chiara Pagani
- Department of Diagnostic and Interventional Radiology and Neuroradiology, IRCCS San Matteo University Hospital Foundation, Pavia, Italy
| | - Lorenzo Cavagna
- Department of Internal Medicine and Therapeutics, Università di Pavia, Pavia, Italy
- Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, V. le Golgi 19, 27100, Pavia, Italy
| | - Stefano Galletti
- Musculoskeletal Ultrasound School, Italian Society for Ultrasound in Medicine and Biology, Bologna, Italy
| | - Carlomaurizio Montecucco
- Department of Internal Medicine and Therapeutics, Università di Pavia, Pavia, Italy
- Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, V. le Golgi 19, 27100, Pavia, Italy
| |
Collapse
|
25
|
Axelrod DE, Ekhtiari S, Winemaker MJ, de Beer J, Wood TJ. Management of Greater Trochanteric Pain Syndrome After Total Hip Arthroplasty: Practice Patterns and Surgeon Attitudes. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202312000-00005. [PMID: 38048139 PMCID: PMC10697621 DOI: 10.5435/jaaosglobal-d-23-00085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 09/11/2023] [Accepted: 09/23/2023] [Indexed: 12/05/2023]
Abstract
INTRODUCTION Greater trochanteric pain syndrome (GTPS) or trochanteric bursitis is described as pain on the lateral side of the hip that does not involve the hip joint and can be elicited clinically by palpation over the greater trochanter. To date, there remains no consensus on clinical guidelines for either diagnosis or management of GTPS. METHODS To understand the practice patterns, beliefs, and attitudes relating to the management of GTPS after total hip arthroplasty, a survey was developed and completed by Canadian arthroplasty surgeons. The final survey consisted of 23 questions divided into three sections: 1) screening questions; 2) demographic information; and 3) practice patterns, attitudes, and beliefs. RESULTS Most surgeons use physical examination alone for diagnosis. A detailed analysis indicates that surgeons primarily treat GTPS with oral anti-inflammatories (57.1%), structured physiotherapy (52.4%), and steroid injections (45.2%). Management options are typically nonsurgical and comprise a combination of either unstructured or targeted physiotherapy, corticosteroid injections, or platelet-rich plasma. DISCUSSION There remains an absence of clinical consensus for the diagnosis and management of GTPS after total hip arthroplasty. Physical examination is most often relied on, regardless of the availability of imaging aids. While common treatments of GTPS were identified, up to one-third of patients fail initial therapy.
Collapse
Affiliation(s)
- Daniel E. Axelrod
- From the Division of Orthopaedic Surgery, McMaster University, Hamilton, ON (Dr. Axelrod, Dr. Ekhtiari, Dr. Winemaker, and Dr. Wood), and the Hamilton Arthroplasty Group, Hamilton Health Sciences, Ontario, Canada (Dr. Winemaker and Dr. Wood)
| | - Seper Ekhtiari
- From the Division of Orthopaedic Surgery, McMaster University, Hamilton, ON (Dr. Axelrod, Dr. Ekhtiari, Dr. Winemaker, and Dr. Wood), and the Hamilton Arthroplasty Group, Hamilton Health Sciences, Ontario, Canada (Dr. Winemaker and Dr. Wood)
| | - Mitchell J. Winemaker
- From the Division of Orthopaedic Surgery, McMaster University, Hamilton, ON (Dr. Axelrod, Dr. Ekhtiari, Dr. Winemaker, and Dr. Wood), and the Hamilton Arthroplasty Group, Hamilton Health Sciences, Ontario, Canada (Dr. Winemaker and Dr. Wood)
| | - Justin de Beer
- From the Division of Orthopaedic Surgery, McMaster University, Hamilton, ON (Dr. Axelrod, Dr. Ekhtiari, Dr. Winemaker, and Dr. Wood), and the Hamilton Arthroplasty Group, Hamilton Health Sciences, Ontario, Canada (Dr. Winemaker and Dr. Wood)
| | - Thomas J. Wood
- From the Division of Orthopaedic Surgery, McMaster University, Hamilton, ON (Dr. Axelrod, Dr. Ekhtiari, Dr. Winemaker, and Dr. Wood), and the Hamilton Arthroplasty Group, Hamilton Health Sciences, Ontario, Canada (Dr. Winemaker and Dr. Wood)
| |
Collapse
|
26
|
Lin HW, Tam KW, Liou TH, Rau CL, Huang SW, Hsu TH. Efficacy of Platelet-Rich Plasma Injection on Range of Motion, Pain, and Disability in Patients With Adhesive Capsulitis: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2023; 104:2109-2122. [PMID: 37119955 DOI: 10.1016/j.apmr.2023.03.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To investigate the therapeutic effects of platelet-rich plasma (PRP) injection on range of motion, pain, and disability in patients with adhesive capsulitis (AC). DATA SOURCES The authors performed the literature search in the PubMed, Embase, and Cochrane Library databases in February 2023. STUDY SELECTION Prospective studies comparing the outcomes of PRP with other intervention in patients with AC. DATA EXTRACTION The quality of included randomized trials was assessed using the revised Cochrane Risk of Bias (RoB 2.0) tool. The Risk of Bias in Non-Randomized Studies of Interventions tool was applied to assess the quality of nonrandomized trials. The mean difference (MD) or standardized mean difference (SMD) was determined as the effect size for continuous outcomes, and outcome accuracy was determined using 95% confidence intervals (CIs). DATA SYNTHESIS Fourteen studies involving 1139 patients were included. Our meta-analysis revealed that PRP injection can significantly improve passive abduction (MD=3.91; 95% CI, 0.84-6.98), passive flexion (MD=3.90; 95% CI, 0.15-7.84), and disability (SMD=-0.50; 95% CI, -1.29 to -0.74) within 1 month after intervention. Moreover, PRP injection can significantly improve passive abduction (MD=17.19; 95% CI, 12.38-22.01), passive flexion (MD=17.74; 95% CI, 9.89-25.59), passive external rotation (MD=12.95; 95% CI, 10.04-15.87), pain (MD=-8.40; 95% CI, -16.73 to -0.06), and disability (SMD=-1.02; 95% CI, -1.29 to -0.74) 3 months after intervention. PRP injection can also significantly improve pain (MD=-18.98; 95% CI, -24.71 to -13.26), and disability (SMD=-2.01; 95% CI, -3.02 to -1.00) 6 months after intervention. In addition, no adverse effects of PRP injection were reported. CONCLUSIONS PRP injection may serve as an effective and safe treatment for patients with AC.
Collapse
Affiliation(s)
- Ho-Wei Lin
- School of Medicine, College of Medicine, Taipei Medical University, Taipei City
| | - Ka-Wai Tam
- Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Cochrane Taiwan, Taipei Medical University, Taipei City; Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei City
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Chi-Lun Rau
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Tzu-Herng Hsu
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.
| |
Collapse
|
27
|
Dimitri-Pinheiro S, Klontzas ME, Vassalou EE, Pimenta M, Soares R, Karantanas AH. Long-Term Outcomes of Ultrasound-Guided Hydrodistension for Adhesive Capsulitis: A Prospective Observational Study. Tomography 2023; 9:1857-1867. [PMID: 37888739 PMCID: PMC10610723 DOI: 10.3390/tomography9050147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/04/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023] Open
Abstract
Ultrasound-guided hydrodistention has been established as an effective minimally invasive treatment option for glenohumeral joint adhesive capsulitis (AC). Nonetheless, the long-term outcomes of the procedure have not yet been established. A total of 202 patients with AC were prospectively recruited and followed up for a total of 2 years. Pain and functionality were assessed with the use of the visual analogue scale (VAS) and the disabilities of the arm, shoulder, and hand (DASH) score, respectively, at the beginning and the end of the follow-up period. The relapse of AC over the 2-year period and the effect of diabetes were also evaluated in the treatment cohort. The Mann-Whitney U test was used to compare mean scores at the two time points, and Cox survival analysis and χ2 test were used to assess the effect of diabetes on AC relapse. VAS and DASH scores were significantly lower at 2 years compared with the beginning of the follow-up period (p < 0.001). Diabetes was diagnosed in 38/202 patients (18.8%) and was found to be significantly associated with recurrence of the disease (p < 0.001). In conclusion, in this observational study, we have demonstrated that ultrasound-guided hydrodistention is linked to excellent long-term outcomes for the treatment of AC, which are significantly worse in patients with diabetes.
Collapse
Affiliation(s)
- Sofia Dimitri-Pinheiro
- Radiology Department, Portuguese Institute of Oncology of Porto—Francisco Gentil EPE, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;
- Unit of Biochemistry, Biomedicine Department, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal;
| | - Michail E. Klontzas
- Department of Medical Imaging, University Hospital of Heraklion, 71110 Heraklion, Crete, Greece; (M.E.K.); (E.E.V.)
- Department of Radiology, School of Medicine, University of Crete, Voutes Campus, 71003 Heraklion, Crete, Greece
| | - Evangelia E. Vassalou
- Department of Medical Imaging, University Hospital of Heraklion, 71110 Heraklion, Crete, Greece; (M.E.K.); (E.E.V.)
| | - Madalena Pimenta
- Radiology Department, São João Hospital Centre, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal;
| | - Raquel Soares
- Unit of Biochemistry, Biomedicine Department, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal;
- I3S—Institute for Innovation and Health Research, University of Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
| | - Apostolos H. Karantanas
- Department of Medical Imaging, University Hospital of Heraklion, 71110 Heraklion, Crete, Greece; (M.E.K.); (E.E.V.)
- Department of Radiology, School of Medicine, University of Crete, Voutes Campus, 71003 Heraklion, Crete, Greece
| |
Collapse
|
28
|
Bensler S. [Subacromial shoulder impingement]. Radiologie (Heidelb) 2023; 63:771-778. [PMID: 37707546 DOI: 10.1007/s00117-023-01209-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/15/2023]
Abstract
Impingement, especially subacromial impingement, is one of the most frequent causes of shoulder pain. It results in soft tissue pathologies due to constriction of the subacromial space. It can lead to tendon pathologies and bursitis. In addition to the clinical examination, imaging methods such as magnetic resonance imaging (MRI), MRI arthrography, ultrasound and X‑ray examinations are helpful in making a diagnosis or evaluating the cause of pain. Conservative treatment approaches, such as rest, medication, physiotherapy, manual therapy and infiltrations should primarily be used. If the symptoms do not improve after 3-6 months of conservative treatment, surgical treatment should be considered.
Collapse
Affiliation(s)
- Susanne Bensler
- Institut für Radiologie, Kantonsspital Baden, Im Ergel 1, 5404, Baden, Schweiz.
| |
Collapse
|
29
|
Harper KD, Park KJ, Incavo SJ. Management of Hip Abductor Tears and Recalcitrant Trochanteric Bursitis in Native Hips. J Am Acad Orthop Surg 2023; 31:e769-e777. [PMID: 37647539 DOI: 10.5435/jaaos-d-23-00224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/10/2023] [Indexed: 09/01/2023] Open
Abstract
Hip abductor tears have recently gained recognition as a more prevalent injury than previously thought. This article will detail the pathophysiology of injury, physical symptoms commonly found at presentation, diagnostic imaging to best diagnose tears and when they should be ordered, and how to properly classify the injury and finally summarize the treatment options available with expert opinions about which are most successful.
Collapse
Affiliation(s)
- Katharine D Harper
- From the Department of Orthopedic Surgery, Washington DC Veterans Affairs Medical Center, Washington, DC (Harper and Incavo) and the Department of Orthopedics & Sports Medicine, Houston Methodist Hospital, Houston, Texas (Park)
| | | | | |
Collapse
|
30
|
Spinnato P, Masuzzo O, Tuè G, Tucci F, Bevere A, Vita F, Cavallo M, Marinelli A, Miceli M. A Novel Ultrasound-Guided Interventional Procedure for the Combined Treatment of Rotator Cuff Calcific Tendinopathy Complicated with Adhesive Capsulitis: The 'Rizzoli' Technique. Acad Radiol 2023; 30:2437-2438. [PMID: 37198078 DOI: 10.1016/j.acra.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 04/15/2023] [Accepted: 04/15/2023] [Indexed: 05/19/2023]
Affiliation(s)
- Paolo Spinnato
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (P.S., O.M., G.T., F.T., A.B., M.M.); 1st Orthopaedics and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (F.V.); Shoulder and Elbow Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (M.C., A.M.).
| | - Oriana Masuzzo
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (P.S., O.M., G.T., F.T., A.B., M.M.); 1st Orthopaedics and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (F.V.); Shoulder and Elbow Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (M.C., A.M.)
| | - Giovanni Tuè
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (P.S., O.M., G.T., F.T., A.B., M.M.); 1st Orthopaedics and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (F.V.); Shoulder and Elbow Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (M.C., A.M.)
| | - Francesco Tucci
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (P.S., O.M., G.T., F.T., A.B., M.M.); 1st Orthopaedics and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (F.V.); Shoulder and Elbow Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (M.C., A.M.)
| | - Antonio Bevere
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (P.S., O.M., G.T., F.T., A.B., M.M.); 1st Orthopaedics and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (F.V.); Shoulder and Elbow Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (M.C., A.M.)
| | - Fabio Vita
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (P.S., O.M., G.T., F.T., A.B., M.M.); 1st Orthopaedics and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (F.V.); Shoulder and Elbow Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (M.C., A.M.)
| | - Marco Cavallo
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (P.S., O.M., G.T., F.T., A.B., M.M.); 1st Orthopaedics and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (F.V.); Shoulder and Elbow Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (M.C., A.M.)
| | - Alessandro Marinelli
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (P.S., O.M., G.T., F.T., A.B., M.M.); 1st Orthopaedics and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (F.V.); Shoulder and Elbow Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (M.C., A.M.)
| | - Marco Miceli
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (P.S., O.M., G.T., F.T., A.B., M.M.); 1st Orthopaedics and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (F.V.); Shoulder and Elbow Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (M.C., A.M.)
| |
Collapse
|
31
|
Kirker K, O’Connell M, Bradley L, Torres-Panchame RE, Masaracchio M. Manual therapy and exercise for adhesive capsulitis: a systematic review with meta-analysis. J Man Manip Ther 2023; 31:311-327. [PMID: 36861780 PMCID: PMC10566414 DOI: 10.1080/10669817.2023.2180702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/08/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Adhesive capsulitis (AC) affects approximately 1% of the general population. Current research lacks clear guidance on the dosage of manual therapy and exercise interventions. OBJECTIVE The purpose of this systematic review was to assess the effectiveness of manual therapy and exercise in the management of AC, with a secondary aim of describing the available literature present on the dosage of interventions. METHODS Eligible studies were randomized clinical/quasi-experimental trials with complete data analysis and no limits on date of publication, published in English, recruited participants >18 years of age with primary adhesive capsulitis, that had at least two groups with one group receiving manual therapy (MT) alone, exercise alone, or MT and exercise, that included at least one outcome measure of pain, disability, or external rotation range of motion, and that had dosage of visits clearly defined. An electronic search was conducted using PubMed, Embase, Cochrane, Pedro, and clinicaltrials.gov. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias 2 Tool. The Grading of Recommendations Assessment, Development, and Evaluation was used to provide an overall assessment of the quality of evidence. Meta-analyses were conducted when possible, and dosage was discussed in narrative form. RESULTS Sixteen studies were included. All meta-analyses revealed non-significant effects of pain, disability, and external rotation range of motion at short- and long-term follow-up, with an overall level of evidence ranging from very low to low. CONCLUSION Non-significant findings with low-to-very-low-quality of evidence were found across meta-analyses, preventing seamless transition of research evidence to clinical practice. Lack of consistency in study designs, manual therapy techniques, dosing parameters, and duration of care impedes the ability to make strong recommendations regarding optimal dosage of physical therapy for individuals with AC.
Collapse
Affiliation(s)
- Kaitlin Kirker
- Department of Physical Therapy, Long Island University, 1 University Plaza, Brooklyn, NY, United States
| | - Melanie O’Connell
- Department of Physical Therapy, Long Island University, 1 University Plaza, Brooklyn, NY, United States
| | - Lisa Bradley
- Department of Physical Therapy, Long Island University, 1 University Plaza, Brooklyn, NY, United States
| | | | - Michael Masaracchio
- Department of Physical Therapy, Long Island University, 1 University Plaza, Brooklyn, NY, United States
| |
Collapse
|
32
|
Baradaran A, Ebrahimzadeh MH, Sabzevari S, Baradaran A, Razi S, Kachooei AR. Is there any advantage between using continuous passive motion and conventional physical therapy in patients with primary adhesive capsulitis?: A systematic review and meta-analysis. J Bodyw Mov Ther 2023; 36:133-141. [PMID: 37949549 DOI: 10.1016/j.jbmt.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/18/2023] [Accepted: 06/05/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND We are unsure if continuous passive motion (CPM) has any role in the nonoperative management of the Primary Stiff Shoulder (frozen shoulder). We hypothesized that there is no difference in pain improvement, range of motion, and function with or without CPM in patients with a primary stiff shoulder. METHOD We searched the databases for clinical trials comparing CPM versus no-CPM physiotherapy. In the final step, we reviewed five randomized clinical trials. We collected the data of Constant Shoulder Score (CSS), the visual analog scale of pain, shoulder pain and disability index (SPADI), and range of motion (flexion, abduction, external and internal rotation). We used a random-effects model to analyze the data. RESULTS Five studies with a total of 224 patients were included. There were 113 patients in the CPM arm and 111 in the control arm. Both the CPM and control groups showed significant improvements in all measured parameters compared to the first visit after 8-24 weeks. Meta-analysis of pooled data showed significant differences in pain improvement, forward flexion, and CSS favoring the CPM. Still, there was no significant difference in abduction, external and internal rotation, and SPADI. DISCUSSION The CPM seems to be slightly effective in improving pain and motion in the short term, but its long-term efficacy is still under question. The extra cost and time must be considered when offering the CPM.
Collapse
Affiliation(s)
- Ashkan Baradaran
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Family Medicine, McGill University, Canada
| | | | - Soheil Sabzevari
- Weill Cornell University, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Shiva Razi
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir R Kachooei
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Rothman Orthopaedics Florida at AdventHealth, Orlando, USA; Department of Orthopaedic Surgery, University of Central Florida, Florida, USA.
| |
Collapse
|
33
|
Fernandes MR, Assis FMD, Spagnol JE, Chaves VB. Immobilization, Lymphedema, and Obesity are Predictive Factors in the Development of Adhesive Capsulitis in Breast Cancer Patients. Rev Bras Ginecol Obstet 2023; 45:e594-e602. [PMID: 37944926 PMCID: PMC10635792 DOI: 10.1055/s-0043-1772479] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 07/14/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE Adhesive capsulitis is a condition characterized by shoulder pain and stiffness. Breast cancer treatment has been linked to the development of this condition, but its mechanisms are still little known. This study's objective was to identify predictors factors associated with the development of adhesive capsulitis in breast cancer patients. METHODS A case control study was performed with women undergoing treatment for breast cancer in a single center. The sampling was nonprobabilistic and consecutive. Adhesive capsulitis was defined as constant pain associated with decreased active and passive shoulder movement in anterior elevation, external rotation at 0°/90° abduction, and internal rotation at 90° abduction. The study group consisted of patients with shoulder pain and range of motion limitations, while the control group consisted of women without any shoulder abnormalities. Sociodemographic and clinical variables were collected. A univariate logistic regression was used to assess the influence of variables on the studied outcome. For p < 0.20, a multivariate logistic regression was used. The probability of null hypothesis rejection was 5%. RESULTS A total of 145 women were assessed, with 39 (26.9%) on the study group and 106 (73.1%) on the control group. The majority was under 60 years old. In the multivariate analysis, variables correlated to the outcome under study were shoulder immobilization (OR = 3.09; 95% CI: 1.33-7.18; p = 0.009), lymphedema (OR = 5.09; 95% CI: 1.81-14.35; p = 0.002), and obesity (OR = 3.91; 95% CI: 1.27-12.01; p = 0.017). CONCLUSION Lymphedema, postsurgery immobilization, and obesity are predictive factors for the development of adhesive capsulitis in breast cancer patients.
Collapse
|
34
|
Featherall J, Christensen GV, Mortensen AJ, Wheelwright JC, Chalmers PN, Tashjian RZ. Arthroscopic scapulothoracic bursectomy with and without superomedial angle scapuloplasty: a comparison of patient-reported outcomes. J Shoulder Elbow Surg 2023; 32:1945-1952. [PMID: 37075938 DOI: 10.1016/j.jse.2023.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 03/02/2023] [Accepted: 03/22/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Operative treatment of scapulothoracic bursitis most commonly comprises arthroscopic scapulothoracic bursectomy with or without partial superomedial angle scapuloplasty. There is currently no consensus regarding whether or when scapuloplasty should be performed. Prior studies are limited to small case series, and optimal surgical indications are not yet established. The purposes of this study were (1) to retrospectively review patient-reported outcomes of arthroscopic treatment of scapulothoracic bursitis and (2) to compare outcomes between scapulothoracic bursectomy alone and bursectomy with scapuloplasty. We hypothesized that bursectomy with scapuloplasty would provide superior pain relief and functional improvement. MATERIALS AND METHODS All cases of scapulothoracic débridement with or without scapuloplasty completed at a single academic center from 2007 through August 2020 were reviewed. Patient demographic characteristics, symptomatology data, physical examination findings, and corticosteroid injection response data were collected from the electronic medical record. Visual analog scale pain, American Shoulder and Elbow Surgeons, Simple Shoulder Test, and Single Assessment Numeric Evaluation scores were collected. Comparisons between the group undergoing bursectomy alone and the group undergoing bursectomy with scapuloplasty were made using the Student t test for continuous variables and the Fisher exact test for categorical variables. RESULTS Thirty patients underwent scapulothoracic bursectomy alone, and 38 patients underwent bursectomy with scapuloplasty. Final follow-up data were available for 56 of 68 cases (82%). Final postoperative visual analog scale pain scores (3.4 ± 2.2 and 2.8 ± 2.2, respectively; P = .351), American Shoulder and Elbow Surgeons scores (75.8 ± 17.7 and 76.5 ± 22.5, respectively; P = .895), and Simple Shoulder Test scores (8.8 ± 2.3 and 9.5 ± 2.8, respectively; P = .340) were similar between the bursectomy-alone and bursectomy-with-scapuloplasty groups. CONCLUSION Both arthroscopic scapulothoracic bursectomy alone and bursectomy with scapuloplasty are effective treatments for scapulothoracic bursitis. Operative time is shorter without scapuloplasty. In this retrospective series, these procedures showed similar outcomes regarding shoulder function, pain, surgical complications, and rates of subsequent shoulder surgery. Further studies with a focus on 3-dimensional scapular morphology may help optimize patient selection for each of these procedures.
Collapse
Affiliation(s)
- Joseph Featherall
- Department of Orthopaedic Surgery, University of Utah Health, Salt Lake City, UT, USA
| | - Garrett V Christensen
- Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Alexander J Mortensen
- Department of Orthopaedic Surgery, University of Utah Health, Salt Lake City, UT, USA
| | - John C Wheelwright
- Department of Orthopaedic Surgery, University of Utah Health, Salt Lake City, UT, USA
| | - Peter N Chalmers
- Department of Orthopaedic Surgery, University of Utah Health, Salt Lake City, UT, USA
| | - Robert Z Tashjian
- Department of Orthopaedic Surgery, University of Utah Health, Salt Lake City, UT, USA.
| |
Collapse
|
35
|
Whelan G, Yeowell G, Littlewood C. The impact of introducing hydrodistension as a treatment for frozen shoulder in a primary care musculoskeletal service: A retrospective audit. Musculoskeletal Care 2023; 21:953-957. [PMID: 36694385 DOI: 10.1002/msc.1736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 01/15/2023] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Hydrodistension, where a relatively high volume of local anaesthetic, corticosteroid, and sterile saline are injected into the shoulder joint, is a treatment of interest for frozen shoulder. In the UK National Health Service this is typically provided in the hospital setting. In 2017 we introduced hydrodistension into our physiotherapy led musculoskeletal service. This report describes the findings from our audit of onward referral for orthopaedic assessment following the introduction of hydrodistension to our frozen shoulder treatment pathway. METHODS A retrospective audit of data from 102 patients who followed our hydrodistension treatment pathway for frozen shoulder since 2017 was conducted. All 102 patients received at least one hydrodistension procedure performed by a physiotherapist. This involved injecting the glenohumeral joint with a combination of local anaesthetic, corticosteroid, and saline under ultrasound guidance with a total volume of 25-35 mls. This data was compared to the outcomes of 102 patients who presented with frozen shoulder prior to 2017 who did not receive hydrodistension. RESULTS Of 102 patients who received hydrodistension within the musculoskeletal service, six patients required onward referral to orthopaedics. Of the 102 patients who did not receive hydrodistension prior to 2017, 58 required onward referral to orthopaedics. CONCLUSION We report a reduction in onward referral to orthopaedics following the introduction of hydrodistension to our physiotherapist-led treatment pathway for patients with frozen shoulder. This preliminary data identifies the need to further evaluate the clinical and cost-effectiveness of hydrodistension performed by physiotherapists for patients with frozen shoulder.
Collapse
Affiliation(s)
- Gareth Whelan
- York and Scarborough Teaching Hospitals NHS FT, York, UK
| | | | | |
Collapse
|
36
|
Wise SR, Seales P, Houser AP, Weber CB. Frozen Shoulder: Diagnosis and Management. Curr Sports Med Rep 2023; 22:307-312. [PMID: 37678349 DOI: 10.1249/jsr.0000000000001097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
ABSTRACT Frozen shoulder is a common condition that causes pain and restriction of movement of the shoulder unrelated to secondary causes. It has three classic phases (freezing, frozen, and thawing), and is resolved in most cases within 1 to 2 years. Diagnosis is clinical based on global motion restriction and pain. Imaging plays an ancillary role to narrow the differential diagnosis. Physical therapy, nonsteroidal anti-inflammatories, and injection therapies are standard treatments, although none have been shown to alter the long-term course of the condition. Ultrasound guidance is recommended for injection-based therapy, although not required. Further study should focus on long-term outcomes and treatments that significantly alter the natural course of the disease.
Collapse
Affiliation(s)
- Sean R Wise
- National Capital Consortium Military Sports Medicine Fellowship, Fort Belvoir Community Hospital, Fort Belvoir, VA
| | | | | | - Chase B Weber
- National Capital Consortium Family Medicine Residency, Fort Belvoir Community Hospital, Fort Belvoir, VA
| |
Collapse
|
37
|
Flores-Villalobos A, Cruz-López F, Cuevas-Rodríguez G, Hernández-León J. Arthrodilation: a treatment algorithm as a conservative management option for adhesive capsulitis. Acta Ortop Mex 2023; 37:255-263. [PMID: 38382449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
INTRODUCTION the management of adhesive capsulitis (AC) remains a topic of debate among orthopedic surgeons, with a wide variation in the literature. Conservative treatment relies as the first-line option as clinical studies report positive outcomes. However, there is variability in the effectiveness of different treatment modalities. MATERIAL AND METHODS this study aimed to analyzed functional and clinical outcomes of patients with AC who underwent the arthrodilation protocol, including three ultrasound-guided injections administered on a weekly basis: two corticosteroid injections and one injection of hyaluronic acid combined with corticosteroids. Additionally, patients received a specific rehabilitation therapy. Visual analogue scale (VAS), the university of California-Los Angeles shoulder score (UCLA) and Constant-Murley score were assessed before treatment and after 3-month follow-up period. RESULTS 23 patients were included, receiving the same treatment protocol with a mean onset of symptoms of 4.9 ± 1.7 months. Among these patients, there was a clear predominance of females (65.2%). Age distribution ranged from 39 to 74 years (mean = 56) indicating that individuals in their mid-50s were more susceptible to developing this condition. Furthermore, a slight majority (52.2%) exhibited AC in their right shoulder. VAS significantly decreased (-6.09 ± 1.9 [p 0.05]). Similarly, UCLA score (10.9 ± 2.9 to 31.7 ± 2.2) and Constant-Murley score (22.3 ± 6.1 to 62.0 ± 6.2) improved significantly. Pre-to-post treatment evaluation showed improvement in both UCLA (mean = 20.8 ± 2.9 [p 0.05]) and Constant-Murley (mean = 39.7 ± 9 [p 0.05]). CONCLUSION arthrodilation protocol demonstrated promising results, with patients achieving good to excellent outcomes and safely resuming their regular daily activities within a short-term follow-up period. These findings provide support for arthrodilation as a viable conservative management option and contribute valuable insights to the ongoing research aimed at identifying optimal treatment approaches for adhesive capsulitis.
Collapse
Affiliation(s)
- A Flores-Villalobos
- Ortopedia del Deporte de Alto Rendimiento, Instituto Nacional de Rehabilitación «Luis Guillermo Ibarra Ibarra». Ciudad de México. México
| | - F Cruz-López
- Ortopedia del Deporte de Alto Rendimiento, Instituto Nacional de Rehabilitación «Luis Guillermo Ibarra Ibarra». Ciudad de México. México
| | - G Cuevas-Rodríguez
- Ortopedia del Deporte de Alto Rendimiento, Instituto Nacional de Rehabilitación «Luis Guillermo Ibarra Ibarra». Ciudad de México. México
| | - J Hernández-León
- Ortopedia del Deporte de Alto Rendimiento, Instituto Nacional de Rehabilitación «Luis Guillermo Ibarra Ibarra». Ciudad de México. México
| |
Collapse
|
38
|
Abstract
Frozen shoulder (FS) is a common condition with no defined optimal therapy. Tuina therapy, a traditional Chinese medicine (TCM) technique used to treat FS patients in Chinese hospitals, has demonstrated excellent results, but its mechanisms are not fully understood. Building on a previous study, this work aimed to develop a Tuina protocol for an FS rat model. We randomly divided 20 SD rats into control (C; n = 5), FS model (M; n = 5), FS model Tuina treatment (MT; n = 5), and FS model oral treatment (MO; n = 5) groups. This study used the cast immobilization method to establish the FS rat model. The effect of Tuina and oral dexamethasone on the glenohumeral range of motion (ROM) was evaluated, and the histological findings were assessed. Our study showed that Tuina and oral dexamethasone were able to improve shoulder active ROM and preserve the structure of the capsule, with Tuina therapy proving to be more effective than oral dexamethasone. In conclusion, the Tuina protocol established in this study was highly effective for FS.
Collapse
Affiliation(s)
- Yingjie Qiao
- College of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine
| | | | - Jianmin Wang
- Department of Tuina, Shandong University of Traditional Chinese Medicine Affiliated Hospital
| | - Muzhen Li
- College of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine
| | - Lijun Zheng
- College of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine
| | - Huadong Li
- Department of Tuina, Shandong University of Traditional Chinese Medicine Affiliated Hospital;
| | - Shidong Zhang
- College of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine
| |
Collapse
|
39
|
Skelly DL, Konieczko EM, Ulrich J. Rice bodies in a shoulder bursa: a cadaveric and histologic case report. J Man Manip Ther 2023; 31:206-213. [PMID: 36309809 PMCID: PMC10288894 DOI: 10.1080/10669817.2022.2138153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION The subacromial/subdeltoid bursa can develop inflammation and effusion related to autoimmune, infectious, and musculoskeletal disorders. Rice bodies, or loose bodies within bursa, have been described as an uncommon complication of bursitis and have been the subject of case studies over a number of years. However, they have not been described in anatomical or physical therapy-related literature. METHODS A donor body dissected for a physical therapy anatomy course was found to have an enlarged subacromial/subdeltoid bursa. This bursa, along with the biceps brachii tendon sheath, and the subscapularis muscle bursa, were filled with numerous rice-like bodies. The bursal wall was well developed and thickened. Tissue specimens were obtained of the suspected rice bodies, the subacromial/subdeltoid bursal wall, and the biceps brachii tendon sheath. The tissue was embedded, sectioned, and processed with hematoxylin and eosin or Masson's Trichrome staining for blinded histologic assessment. RESULTS The tissue samples from within the bursa were identified as tissue similar to that in prior descriptions of rice bodies. Tissue samples from the bursal wall and tendon sheath were identified as similar to synovial membranes. CONCLUSIONS Rice bodies found within the cadaveric body were similar histologically to those described in rheumatology, radiology, and orthopedic literature. Anatomists teaching future health-care providers and practicing physical therapists should be familiar with rice bodies as a potential finding in cadavers, and patients.
Collapse
|
40
|
Zhao HY, Han CH, Yang C, Lee YJ, Ha IH, Park KS. Effectiveness of Pharmacopuncture Therapy in Adhesive Capsulitis: a Study Protocol for a Pragmatic Randomized Controlled Trial. J Acupunct Meridian Stud 2023; 16:70-78. [PMID: 37076182 DOI: 10.51507/j.jams.2023.16.2.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/05/2022] [Accepted: 03/25/2023] [Indexed: 04/21/2023] Open
Abstract
Background Adhesive capsulitis is a progressive, idiopathic disorder that significantly impacts individuals̓ daily lives and increases their medical burden. Pharmacopuncture therapy, which combines acupuncture techniques with herbal medicine, involves injecting herbal extracts into specific acupoints. This study aims to determine the effectiveness and safety of pharmacopuncture therapy in comparison to physiotherapy (PT) for treating adhesive capsulitis. Methods This research protocol outlines a two-arm, parallel, multi-center, pragmatic randomized controlled trial. Fifty participants will be randomly allocated to either the pharmacopuncture therapy or PT group, and they will receive 12 sessions of their respective therapies over a 6-week period. The primary outcome measure is the numeric rating scale for shoulder pain. Secondary outcomes include the visual analog scale score for shoulder pain, Shoulder Pain and Disability Index, Patients̓ Global Impression of Change score, Short Form-12 Health Survey Version 2 score, and EuroQol-5 Dimension. Statistical analysis will be conducted based on the intention-to-treat principle. Discussion This trial may offer high-quality and reliable clinical evidence for evaluating the effectiveness and safety of pharmacopuncture therapy compared to PT in the treatment of adhesive capsulitis. Furthermore, this study will serve as a valuable guideline for practitioners when making clinical decisions and managing adhesive capsulitis.
Collapse
Affiliation(s)
- Hui Yan Zhao
- Korean Convergence Medical Science, University of Science & Technology (UST), School of Korea Institute of Oriental Medicine, Daejeon, Korea
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Chang-Hyun Han
- Korean Convergence Medical Science, University of Science & Technology (UST), School of Korea Institute of Oriental Medicine, Daejeon, Korea
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Changsop Yang
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Korea
| | | |
Collapse
|
41
|
Talaie R, Torkian P, Golzarian J. Knee and Shoulder Vascular Anatomy. Tech Vasc Interv Radiol 2023; 26:100877. [PMID: 36889840 DOI: 10.1016/j.tvir.2022.100877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In the past decade, angiographic studies have demonstrated neovessels in or in the vicinity of affected joints in many musculoskeletal conditions that used to be considered wear and tear joint disease, such as knee osteoarthritis, frozen shoulder, and overuse injuries. The novelty of this finding is showing the presence of neovascularity at an angiographically detectable level, as compared to histologically evident neovessels that had been discovered years ago. These neovessels have now become the target of interventions in a growing field called muscoskeletal embolotherapy. An in-depth and all-encompassing understanding of the vascular anatomy that could specifically assist performing of these procedures is paramount. Such an understanding will help ensure success in clinical outcomes and avoid much dreaded complications. This review discusses the vascular anatomy relevant to the 2 most commonly performed musculoskeletal embolotherapies, genicular artery embolization and transarterial embolization for frozen shoulder.
Collapse
Affiliation(s)
- Reza Talaie
- Vascular and Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, MN.
| | - Pooya Torkian
- Vascular and Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, MN.
| | - Jafar Golzarian
- Vascular and Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, MN.
| |
Collapse
|
42
|
Pimenta M, Vassalou EE, Dimitri-Pinheiro S, Klontzas ME, Ramos I, Karantanas AH. Ultrasound-Guided Hydrodistension for Adhesive Capsulitis: Is There Any Adjunct Effect of Immediate Post-Procedural Manipulation Over Instructed Physical Therapy? J Ultrasound Med 2023; 42:665-674. [PMID: 35869694 DOI: 10.1002/jum.16063] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/24/2022] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To compare the additive value of immediate post-procedural manipulation versus physiotherapy, following ultrasound (US)-guided hydrodistention of the glenohumeral joint (GHJ) in patients with adhesive capsulitis (AC) and define predictors of outcome. METHODS Within a 19-month period, 161 consecutive patients with AC were prospectively enrolled and allocated to two groups according to treatment, based on patients' individual preferences: 1) group-I, US-guided hydrodistension plus immediate post-procedural manipulations and 2) group-II, US-guided hydrodistension plus supervised physiotherapy program. The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and a visual analog scale (VAS) were used for clinical assessment at baseline (immediately after treatment), 1, 3, and 6 months. Comparisons were performed with Mann-Whitney U test and Kolmogorov-Smirnov test. Linear regression was used to identify predictors of outcome. P value <.05 defined significance. RESULTS GHJ hydrodistension with manipulation or physiotherapy was linked to clinical improvement at all follow-up time-points. DASH scores of group-I remained constantly lower than DASH scores of group-II at all time-points (P < .001). VAS scores were lower in group-I than group-II at 1 and 3 months (P < .001 and P = .0019, respectively). Both groups had improved to a similar degree with respect to pain at 6 months (P = .29). The performance of post-interventional manipulations was predictive of improved shoulder functionality (as assessed with DASH scores) at all time-points, while low-grade disease and milder symptoms at presentation were associated with improved short-term pain. CONCLUSIONS Immediate post-procedural manipulations appeared to be superior to physiotherapy following GHJ hydrodistension for AC in terms of shoulder functionality during a 6-month follow-up period. Post-interventional manipulations, the stage of AC and lower DASH and VAS scores at presentations were predictive of improved outcome.
Collapse
Affiliation(s)
| | | | - Sofia Dimitri-Pinheiro
- Radiology Department, Portuguese Institute of Oncology of Porto - Francisco Gentil EPE, Porto, Portugal
- Biomedicine Department, Unit of Biochemistry, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Michail E Klontzas
- Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece
- Department of Radiology, School of Medicine, University of Crete, Heraklion, Greece
| | - Isabel Ramos
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Apostolos H Karantanas
- Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece
- Department of Radiology, School of Medicine, University of Crete, Heraklion, Greece
| |
Collapse
|
43
|
Leafblad N, Mizels J, Tashjian R, Chalmers P. Adhesive Capsulitis. Phys Med Rehabil Clin N Am 2023; 34:453-468. [PMID: 37003663 DOI: 10.1016/j.pmr.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Adhesive capsulitis, colloquially known as "frozen shoulder," is a relatively common disorder, affecting approximately 2% to 5% of the general population. The incidence may be higher as the condition can be relatively mild and self-limited and thus many patients who experience it may never present for treatment. It involves a pathologic process of gradual fibrosis of the glenohumeral joint that leads to limited active and passive range of motion, contracture of the joint capsule, and shoulder pain.
Collapse
Affiliation(s)
- Nels Leafblad
- Department of Sports Medicine, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.
| | - Josh Mizels
- Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Robert Tashjian
- Department of Shoulder and Elbow Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Peter Chalmers
- Department of Shoulder and Elbow Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| |
Collapse
|
44
|
Uysal B, Özkuk K, Şahin N, Ökmen BM, Sezer R, Ateş Z. Response to the Letter to the Editor by Chen et al. regarding our article "Comparison of the effectiveness of high-intensity laser and ultrasound therapies in adhesive capsulitis: A randomized controlled study". J Back Musculoskelet Rehabil 2023; 36:1215-1216. [PMID: 37545213 DOI: 10.3233/bmr-230125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Affiliation(s)
- Bilal Uysal
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Kağan Özkuk
- Department of Medical Ecology and Hydroclimatology, Faculty of Medicine, Usak University, Usak, Turkey
| | - Nilay Şahin
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Burcu M Ökmen
- Department of Physical Medicine and Rehabilitation, Saglik Bilimleri University Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Refia Sezer
- Department of Physical Medicine and Rehabilitation, İzzet Baysal Physical Medicine and Rehabilitation Training and Research Hospital, Bolu, Turkey
| | - Zeynep Ateş
- Department of Physical Medicine and Rehabilitation, İzzet Baysal Physical Medicine and Rehabilitation Training and Research Hospital, Bolu, Turkey
| |
Collapse
|
45
|
Chen X, Sun P, Xu Z. Response to: "Comparison of the effectiveness of high-intensity laser and ultrasound therapies in adhesive capsulitis: A randomized controlled study". J Back Musculoskelet Rehabil 2023; 36:1213-1214. [PMID: 37545212 DOI: 10.3233/bmr-230123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Affiliation(s)
- Xiuming Chen
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Guangzhou First People's Hospital, Guangzhou, Guangdong, China
| | - Pingxiu Sun
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhanqiong Xu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| |
Collapse
|
46
|
Uysal B, Özkuk K, Şahin N, Ökmen BM, Sezer R, Ateş Z. Comparison of the effectiveness of high-intensity laser and ultrasound therapies in adhesive capsulitis: A randomized controlled study. J Back Musculoskelet Rehabil 2023; 36:227-236. [PMID: 35964170 DOI: 10.3233/bmr-220026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adhesive capsulitis (AC) is a common musculoskeletal disease characterized with shoulder pain, limitation of range of motion (ROM) and disability. Although physical therapy is used in the treatment of AC, studies on its effectiveness are continuing. OBJECTIVE This study aimed to assess the effectiveness of ultrasound (US) and high-intensity laser therapy (HILT) in the treatment of AC. METHODS Sixty patients were randomized into two groups. Group I received US (15 sessions) and Group II received HILT (9 sessions) for 3 weeks. In addition, all patients received physical therapy program (hot pack, TENS and exercises). Assessments were made using VAS-pain, Shoulder Pain and Disability Index (SPADI), range of motion (ROM) at baseline and in post-treatment 3rd, 8th and 24th weeks. RESULTS There was no statistically significant difference between the groups in terms of all pre-treatment values. In intragroup assessment, statistically significant difference was identified in all the values of Groups 1 and 2 in all assessment periods compared with the pre-treatment values (p< 0.05). There was no significant difference between groups in all assessment periods. CONCLUSION According to results, US therapy and HILT were effective on the improvement of pain, ROM and functional conditions of patients in the treatment of AC.
Collapse
Affiliation(s)
- Bilal Uysal
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Kağan Özkuk
- Department of Medical Ecology and Hydroclimatology, Faculty of Medicine, Usak University, Usak, Turkey
| | - Nilay Şahin
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Burcu M Ökmen
- Department of Physical Medicine and Rehabilitation, Saglik Bilimleri University Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Refia Sezer
- Department of Physical Medicine and Rehabilitation, İzzet Baysal Physical Medicine and Rehabilitation Training and Research Hospital, Bolu, Turkey
| | - Zeynep Ateş
- Department of Physical Medicine and Rehabilitation, İzzet Baysal Physical Medicine and Rehabilitation Training and Research Hospital, Bolu, Turkey
| |
Collapse
|
47
|
Papalexis N, Parmeggiani A, Facchini G, Miceli M, Carbone G, Cavallo M, Spinnato P. Current concepts in the diagnosis and treatment of adhesive capsulitis: role of diagnostic imaging and ultrasound-guided interventional procedures. Radiol Med 2022; 127:1390-1399. [PMID: 36376543 DOI: 10.1007/s11547-022-01566-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/30/2022] [Indexed: 11/16/2022]
Abstract
Adhesive capsulitis is a common cause of painful shoulder, characterized by pain and restricted range of motion of the glenohumeral joint. With a well-known clinical presentation, and an increasing understanding of its clinical and radiologic features, early diagnosis of adhesive capsulitis is becoming a reality. Although often treated conservatively, for refractory cases arthroscopic release and open capsulotomy have been the only therapeutic option for a long time. Therefore, in the last years, a particular effort was put into the development of novel minimal-invasive techniques capable of pain relief and functional range improvement of the glenohumeral joint. The purpose of this literature review is to report the main updates on diagnosis and treatment for adhesive capsulitis with a focus on imaging diagnosis techniques and novel minimally invasive ultrasound-guided treatments. Results showed that ultrasound-guided procedures come with a high success rate in terms of pain reduction and improved range of motion, thus making the ultrasound a unique tool capable of giving the operator real-time diagnostic information confirming the clinical suspicion, and subsequently performing an interventional procedure.
Collapse
Affiliation(s)
- Nicolas Papalexis
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via GC Pupilli 1, 40136, Bologna, Italy
| | - Anna Parmeggiani
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via GC Pupilli 1, 40136, Bologna, Italy
| | - Giancarlo Facchini
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via GC Pupilli 1, 40136, Bologna, Italy
| | - Marco Miceli
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via GC Pupilli 1, 40136, Bologna, Italy
| | - Giuseppe Carbone
- Shoulder and Elbow Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marco Cavallo
- Shoulder and Elbow Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Paolo Spinnato
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via GC Pupilli 1, 40136, Bologna, Italy.
| |
Collapse
|
48
|
Dimitri-Pinheiro S, Pinto BS, Pimenta M, Neves JS, Carvalho D. Influence of diabetes on response to ultrasound guided hydrodistension treatment of adhesive capsulitis: a retrospective study. BMC Endocr Disord 2022; 22:227. [PMID: 36096804 PMCID: PMC9465918 DOI: 10.1186/s12902-022-01144-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/11/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Diabetes is associated with microvascular and macrovascular complications. Although it is less recognized, diabetes also has an important role in the development of musculoskeletal disorders. Our objective was to evaluate the effect of type 2 diabetes (T2D) on the severity of adhesive capsulitis of the shoulder (AC) and on the efficacy of ultrasound guided hydrodistension treatment. METHODS We conducted a retrospective longitudinal observational study, of patients with AC who underwent ultrasound guided hydrodistension at our Centre. Severity was measured with DASH (Disabilities of Arm, Shoulder and Hand) score and pain was evaluated with a score between 0 and 10. The association of T2D with baseline characteristics of AC, and with outcomes at 6-12 months was analyzed using linear and logistic regression models. RESULTS We evaluated 120 ultrasound guided hydrodistension treatments of AC, 85 in patients without diabetes and 35 in patients with T2D. Patients with diabetes had a higher prevalence of dyslipidemia, hypertension and higher HbA1c values. The average duration of diabetes was 4.8 years (2.0, 7.9). The baseline characteristics of AC were not significantly different between patients with and without diabetes. Patients with T2D relapsed more frequently and required more reinterventions than patients without diabetes (20.0% vs 4.7%, p = 0.008), had higher post-intervention pain scale values [4.0 (0.0-5.0) vs 0.0 (0.0-5.0), p = 0.022] and higher post-intervention DASH score [0.8 (0.0-1.8) vs 0.0 (0.0-0.8), p = 0.038]. CONCLUSION Although baseline characteristics of AC in patients with diabetes were similar to those without diabetes, patients with diabetes had a worse response to treatment, more frequent relapses and a greater need for new interventions.
Collapse
Affiliation(s)
- Sofia Dimitri-Pinheiro
- Radiology Department, Portuguese Institute of Oncology of Porto – Francisco Gentil EPE, Porto, Portugal
- Biomedicine Department, Unit of Biochemistry, Faculty of Medicine, University of Porto, Porto, Portugal
- Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Beatriz Serpa Pinto
- Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Madalena Pimenta
- Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- CUF Hospital, Porto, Portugal
| | - João Sérgio Neves
- Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Endocrinology Department, São João University Hospital Centre, Porto, Portugal
- Department of Surgery and Physiology, Cardiovascular Research Unit, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Davide Carvalho
- Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Endocrinology Department, São João University Hospital Centre, Porto, Portugal
- I3S - Institute for Innovation and Health Research, University of Porto, Porto, Portugal
| |
Collapse
|
49
|
Jensen J, Vavken P. [Evidence-Based Treatment and Differential Diagnoses of Olecranon Bursitis]. Praxis (Bern 1994) 2022; 111:682-686. [PMID: 36102022 DOI: 10.1024/1661-8157/a003889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Evidence-Based Treatment and Differential Diagnoses of Olecranon Bursitis Abstract. Bursitis olecrani is a common clinical diagnosis that can have systemic, infectious and traumatic causes. In this article we want to present the diagnostics, possible differential diagnoses, complications and the current therapy recommendations as a practical guide.
Collapse
|
50
|
Salomon M, Pastore C, Maselli F, Di Bari M, Pellegrino R, Brindisino F. Manipulation under Anesthesia versus Non-Surgical Treatment for Patients with Frozen Shoulder Contracture Syndrome: A Systematic Review. Int J Environ Res Public Health 2022; 19:9715. [PMID: 35955074 PMCID: PMC9368476 DOI: 10.3390/ijerph19159715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
Purpose: To investigate the efficacy of manipulation under anesthesia (MUA) compared to other non-surgical therapeutic strategies for patients with frozen shoulder contracture syndrome (FSCS). Methods: A systematic review of literature was conducted. A literature search was performed in MEDLINE, EMBASE, PEDro, Cochrane Central Library and Scopus. Only randomized controlled trials were included and assessed for critical appraisal through the Cochrane Collaborations tools. Results: Five randomized controlled trials were included. The overall risk of bias (RoB) was high in 4 out of 5 of the included studies. MUA was found to be not superior in terms of reduction of pain and improvement of function when compared to cortisone injections with hydrodilatation (mean regression coefficient MUA −2.77 vs. injection −2.75; 95% CI (−1.11 to 1.15)) and home exercise (mean difference 95% CI: 0.2 (−0.64 to 1.02)) in the short term (3 months), and cortisone injections with hydrodilatation (mean regression coefficient MUA 3.13 vs. injection 3.23; 95% CI (−0.90 to 1.11)) in the long term (>6 months). Moreover, if compared to structured physiotherapy, MUA highlighted a higher Oxford Shoulder Score at final 1-year follow up (mean difference 95% CI: 1.05 (−1.28 to 3.39); p = 0.38). Similar results were obtained for disability, with statistically no significant long-term (>12 months) differences between MUA and home exercise (mean difference 95% CI: 0 (−3.2 to 3.2)) or structured physiotherapy (mean difference 95% CI: −0.50 (−5.70 to 4.70); p = 0.85)). Only two trials reported adverse events. Conclusions: This review suggested that limited and inconsistent evidence currently exists on the efficacy of MUA compared to other non-surgical strategies in the management of patients with FSCS. Future research should focus on clinical trials with higher methodological quality.
Collapse
Affiliation(s)
- Mattia Salomon
- Department of Clinical Science and Translational Medicine, University of Roma “Tor Vergata”, 00133 Rome, Italy
| | - Chiara Pastore
- Department of Clinical Science and Translational Medicine, University of Roma “Tor Vergata”, 00133 Rome, Italy
| | - Filippo Maselli
- Department of Human Neurosciences, University of Roma “Sapienza”, 00185 Rome, Italy
| | - Mauro Di Bari
- Research Unit of Medicine of Aging, Department of Clinical and Experimental Medicine, University of Florence, 50121 Florence, Italy
- Unit of Geriatrics—Geriatrics Intensive Care Unit, Department of Medicine and Geriatrics, “Careggi Hospital”, 50134 Florence, Italy
| | - Raffaello Pellegrino
- Antalgic Mini-Invasive and Rehab-Outpatients Unit, Department of Medicine and Aging Sciences, University “G. D’Annunzio” Chieti-Pescara, 66100 Chieti, Italy
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano, Switzerland
| | - Fabrizio Brindisino
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, “Cardarelli Hospital”, 86100 Campobasso, Italy
| |
Collapse
|