Ultrasound-guided hydrodilatation for adhesive capsulitis: capsule-preserving versus capsule-rupturing technique.

Autor: Pimenta M; Oporto Armed Forced Hospital, University Clinical Center D. Pedro V, Porto, Portugal.; Faculty of Medicine, University of Porto, Porto, Portugal., Vassalou EE; Department of Medical Imaging, University Hospital of Heraklion, Voutes, 71110, Crete, Greece., Klontzas ME; 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., Dimitri-Pinheiro S; 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., Ramos I; Faculty of Medicine, University of Porto, Porto, Portugal., Karantanas AH; Department of Medical Imaging, University Hospital of Heraklion, Voutes, 71110, Crete, Greece. akarantanas@gmail.com.; Department of Radiology, School of Medicine, University of Crete, Voutes Campus, 71110, Heraklion, Greece. akarantanas@gmail.com.
Jazyk: angličtina
Zdroj: Skeletal radiology [Skeletal Radiol] 2024 Feb; Vol. 53 (2), pp. 253-261. Date of Electronic Publication: 2023 Jul 03.
DOI: 10.1007/s00256-023-04392-7
Abstrakt: 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.
(© 2023. The Author(s).)
Databáze: MEDLINE
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