Effects of Ultrasound-guided intra-articular ketorolac injection with capsular distension

被引:12
作者
Ahn, Jae Ki [1 ]
Kim, Jongwoo [2 ]
Lee, Sang Jae [1 ]
Park, Yongbum [1 ]
Bae, Byung Woo [3 ]
Lee, Woo Yong [4 ]
机构
[1] Inje Univ, Sanggye Paik Hosp, Coll Med, Dept Phys Med & Rehabil, Seoul 139707, South Korea
[2] Inje Univ, Sanggye Paik Hosp, Coll Med, Dept Family Med, Seoul 139707, South Korea
[3] SRC Rehabil Hosipital Gwangju, Inst Rehabil Med, Gyeonggi Do, South Korea
[4] Inje Univ, Sanggye Paik Hosp, Coll Med, Dept Anesthesiol, Seoul 139707, South Korea
关键词
Frozen shoulder; ketorolac; steroid; GLENOHUMERAL JOINT INJECTION; RANDOMIZED CONTROLLED-TRIAL; PLACEBO-CONTROLLED TRIAL; ADHESIVE CAPSULITIS; FROZEN SHOULDER; DOUBLE-BLIND; POSTERIOR APPROACH; MR ARTHROGRAPHY; KNEE; MORPHINE;
D O I
10.3233/BMR-140546
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
BACKGROUND AND OBJECTIVES: Frozen shoulder is a painful condition with gradual onset and loss of range of motion in the glenohumeral joint. To investigate the efficacy of ultrasound(US)-guided intra-articular (IA) ketorolac injection with capsular distension compared with steroid injection alone in patients with frozen shoulder by assessing pain relief, functional improvements, and range of motion at 1,3 and 6 months after the last injections. MATERIAL AND METHOD: Between January 2009 and December 2012, 121 patient were treated with US-guided IA steroid injection or IA ketorolac injection with capsular distension for frozen shoulder. Patients (n = 57) of US-guided IA steroid injection group were administered with a mixture of 0.5% lidocaine (4 ml) plus triamcinolone (40 mg/ml; 1 ml) and patients (n = 64) of US-guided IA ketorolac injection with capsular distension group were administered by using 0.5% lidocaine (19 mL) plus ketorolac (30 mg/ml; 1 mL) for capsular distension. Outcome measurement was assessed by Shoulder Pain and Disability Index (SPADI), Verbal Numeric pain Scale (VNS) and passive range of motion (ROM) before injections and at 1, 3 and 6 months after the last injections. We regarded the outcomes as a success if patients obtained significant pain relief (as measured by > 50% improvement in the VNS score and 20 point improvement in the SPASI) at 1, 3 and 6 months after the last injections. RESULTS: SPADI, VNS and passive ROM were improved 1, 3 and 6 months after the last injections in both groups. The statistical differences were not observed in SPADI, VNS between groups (p < 0.05). Successful treatment rate were not significantly different between the groups as well as in 1, 3 and 6 month outcomes. However, greater improvement was found in a matter of range of motion in patients receiving IA ketorolac injection with capsular distension than participants receiving US-guided IA steroid injection alone. Significant differences in improvement at 3 and 6 months were observed for shoulder passive abduction and external rotation (p < 0.05). CONCLUSION: IA ketorolac injection with capsular distension was shown to be a treatment method as effective as the steroid injection alone in pain relief and functional improvement in patient with frozen shoulder and more improvement in passive abduction and external rotation than steroid injection alone at 3 and 6 months.
引用
收藏
页码:497 / 503
页数:7
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