Article

Intra-articular corticosteroid injection is a commonly used therapy
for adhesive capsulitis, but not enough studies exist on the optimal timing of
the injection. OBJECTIVE:
To determine whether intra-articular corticosteroid
injection has better outcomes in patients with earlier stage than later stage of
adhesive capsulitis. STUDY DESIGN: Retrospective longitudinal study SETTING:
University-affiliated tertiary care hospital. PARTICIPANTS:
Primary adhesive
capsulitis patients (n=339) who were unresponsive to at least 1 month of
conservative treatment and who had ultrasound-guided corticosteroid injection.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUREMENTS: Visual analogue scale,
Shoulder Pain and Disability Index, and passive range of motion (flexion,
abduction, external rotation, and internal rotation and extension) were evaluated
at pretreatment, month 1 and 12 after the first injection.
RESULTS: The result of
the multiple regressions, which considered the main and the interaction effect of
confounding variables, showed that the differences of all outcomes in both
short-term effect at month 1 and long-term effect at month 12 are greater when
the duration of pain prior to injection is shorter. Among the confounders, the
injection number in the difference of internal rotation and extension between
month 0 and 12 (IRE Delta(0-12)) was statistically significant. IRE Delta(0-12)
was also greater when the pain duration was shorter, though the decrease in IRE
Delta(0-12) differed depending on the number of injections. CONCLUSIONS: Early
injection improves outcomes of adhesive capsulitis at both short- and long-term
follow-ups. If pain persists despite non-invasive and conservative treatments,
early injection may be considered to shorten its natural history. LEVEL OF EVIDENCE: III.
CI - Copyright (c) 2018 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS