Good results after fluoroscopic-guided intra-articular injections in the treatment of adhesive capsulitis of the shoulder

Olaf Lorbach, Matthias Kieb, Cornelia Scherf, Romain Seil, Dieter Kohn, Dietrich Pape
Knee Surgery, Sports Traumatology, Arthroscopy 2010, 18 (10): 1435-41
The purpose of the present study was the prospective evaluation of the results of fluoroscopic-guided intra-articular cortisone injection series in the treatment of adhesive capsulitis of the shoulder. Twenty-five patients (9 m, 16 w) with a mean age of 49 ± 8 years and stage II frozen shoulder syndrome according to the Reeves classification were treated with an intra-articular cortisone injection series (3 injections at 0, 4, 12, weeks). Clinical examination, ASES score and SF 36 score were performed at 0, 4, 8, 12 weeks, 6 and 12 months. In the results, significant improvements were seen in flexion (99 ± 30°-119 ± 31°, P < .0001), abduction (72 ± 24-99 ± 34°, P < .0001), external rotation (14 ± 16°-28 ± 21°, P < .0001) and internal rotation already at first follow-up after 4 weeks of treatment. The results were confirmed at any other follow-up. ASES score improved from 28 ± 13 to 45 ± 18 after 4 weeks (P < .0001), 59 ± 21 after 8 weeks (P < .0001), 63 ± 25 at 3 months (P < .0001), 64 ± 28 (P < .0001) at 6 months and 73 ± 27 (P < .0001) points at final follow-up after 1 year. Evaluation of the SF-36 Score showed significant improvements in almost all categories (physical and mental) after 4 weeks of treatment (P < .05). In conclusion, a fluoroscopic-guided intra-articular injection series of cortisone is an effective treatment option in frozen shoulder syndrome leading to a fast pain reduction and increased range motion.

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