Ultrasound-guided Shoulder Intraarticular Ozone Injection Versus Pulsed Radiofrequency Application for Shoulder Adhesive Capsulitis: A Randomized Controlled Trial

被引:0
作者
Foula, Ahmed S. [1 ]
Sabry, Laila S. [1 ]
Elmulla, Ahmed F. [1 ]
Kamel, Maher A. [1 ]
Hozien, Adel Ibrahim [1 ,2 ]
机构
[1] Alexandria Univ, Med Res Inst, Alexandria, Egypt
[2] Alexandria Univ, Med Res Inst, Dept Anesthesia & Pain Management, Alexandria, Egypt
关键词
Adhesive capsulitis; pulsed radiofrequency; ozone; shoulder; glenohumeral joint; pain; hs-CRP; triamcinolone acetonide; PAIN;
D O I
暂无
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: A diseased shoulder due to pain, stiffness, or weakness negatively affects patients' quality of life and their ability to carry out activities of daily living. Adhesive capsulitis is a disease characterized by shoulder pain and global limitation of movement in the shoulder joint. Many interventions have been proposed for the treatment of primary adhesive capsulitis. The current study compares the effect of ultrasound-guided intraarticular injection of ozone versus steroid versus intraarticular application of pulsed radiofrequency. Objectives: The primary outcome of the current study was to compare the improvement in the Visual Analog Scale (VAS) after the 3 treatment modalities. The secondary outcomes included functional improvement measured by the Shoulder Pain and Disability Index (SPADI) and level of inflammatory biomarkers measured by serum intercellular adhesion molecule (ICAM-1) and high sensitivity C-reactive protein(hs-CRP). Study Design: The current study is a prospective, double blinded, randomized controlled trial. We employed a double blinding technique for both the patients and the outcome assessors. Setting: Our study was carried out at the Medical Research Institute, Alexandria University, Egypt, after approval of the local ethical committee (IORG0008812). The study was registered in the "clinical trials library for protocol registration and results system" with number NCT04724317. The study included 45 patients with a diagnosis of primary adhesive capsulitis.Methods: Patients were randomly assigned to 3 equal groups: steroid group, ozone group, and pulsed radiofrequency group. Pain and global shoulder functions were assessed using the VAS at rest and with movement, range of motion (ROM), and the SPADI. Moreover, ICAM-1 and hs-CRP were measured as inflammatory markers. Results: The results of the current study reveal that all patients in all groups have had a statistically significant improvement after their intervention regarding pain, disability, ROM, and inflammatory markers. Pairwise comparisons revealed that improvement of the VAS during movement had a statistically significant improvement starting from the second week and continuing to the fourth and eighth week. VAS during rest had a significant improvement starting from follow-up week one in the steroid group. Moreover, improvement in the ROM and SPADI scores started from the second week follow-up. Percent improvement was calculated for each group and there was a statistically significant difference between groups in VAS at rest and ROM in the pulsed radiofrequency group compared to the steroid group. Regarding inflammatory markers, both ICAM-1 and hs-CRP had a significant improvement after all 3 interventions with no statistically significant difference among the groups. Limitations: This study is a single-center study. A shortage of previously published data, and heterogeneity in the published methodology of the 3 interventions limited our discussion data for comparison with the previous literature.Conclusion: Ultrasound-guided shoulder joint intraarticular injection of steroid, ozone, or pulsed radiofrequency application all result in a significant improvement in pain, disability, and ROM in primary adhesive capsulitis. They can be used as an effective treatment modality for this condition. Comparing groups statistically, the pulsed radiofrequency group had a more delayed, but statistically better long-term improvement compared to the other 2 groups.
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收藏
页码:E329 / E340
页数:12
相关论文
共 31 条
  • [11] High- vs Low-Dose Corticosteroid Injection in the Treatment of Adhesive Capsulitis with Severe Pain: A Randomized Controlled Double-Blind Study
    Kim, Kyou Hyun
    Park, Jong Wook
    Kim, Sang Jun
    [J]. PAIN MEDICINE, 2018, 19 (04) : 735 - 741
  • [12] Kim Yang-Soo, 2013, J Bone Joint Surg Am, V95, pe181, DOI 10.2106/JBJS.K.00525
  • [13] Shoulder adhesive capsulitis: epidemiology and predictors of surgery
    Kingston, Kiera
    Curry, Emily J.
    Galvin, Joseph W.
    Li, Xinning
    [J]. JOURNAL OF SHOULDER AND ELBOW SURGERY, 2018, 27 (08) : 1437 - 1443
  • [14] Le Hai V, 2017, Shoulder Elbow, V9, P75, DOI 10.1177/1758573216676786
  • [15] Inflammatory cytokines are overexpressed in the subacromial bursa of frozen shoulder
    Lho, Yun-Mee
    Ha, Eunyoung
    Cho, Chul-Hyun
    Song, Kwang-Soon
    Min, Byung-Woo
    Bae, Ki-Cheor
    Lee, Kyung-Jae
    Hwang, Ilseon
    Park, Hyung-Bin
    [J]. JOURNAL OF SHOULDER AND ELBOW SURGERY, 2013, 22 (05) : 666 - 672
  • [16] Nonoperative management of adhesive capsulitis of the shoulder: Oral cortisone application versus intra-articular cortisone injections
    Lorbach, Olaf
    Anagnostakos, Konstantinos
    Scherf, Cornelia
    Seil, Romain
    Kohn, Dieter
    Pape, Dietrich
    [J]. JOURNAL OF SHOULDER AND ELBOW SURGERY, 2010, 19 (02) : 172 - 179
  • [17] Pulse-Dose Radiofrequency for Knee Osteoartrithis
    Masala, Salvatore
    Fiori, Roberto
    Raguso, Mario
    Morini, Marco
    Calabria, Eros
    Simonetti, Giovanni
    [J]. CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 2014, 37 (02) : 482 - 487
  • [18] Shoulder manipulation under targeted ultrasound-guided rotator interval block for adhesive capsulitis
    McKean, David
    Yoong, Philip
    Brooks, Rebecca
    Papanikitas, Joseph
    Hughes, Richard
    Pendse, Aniruddha
    McElroy, Bernard John
    [J]. SKELETAL RADIOLOGY, 2019, 48 (08) : 1269 - 1274
  • [19] Mohammad AA, 2018, Iraq Med J, V2, P10
  • [20] Adhesive Capsulitis of the Shoulder
    Neviaser, Andrew S.
    Neviaser, Robert J.
    [J]. JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS, 2011, 19 (09) : 536 - 542