Glenohumeral Corticosteroid Injections in Adhesive Capsulitis: A Systematic Search and Review

Wiley - Tập 6 Số 12 - Trang 1143-1156 - 2014
Amos Amos1,2, Laurence D. Laurence D.1,3, Joel Joel4, Nitin B. Nitin B.1,3,5,6
1Department of Orthopaedic Surgery Brigham and Women's Hospital and Harvard Medical School Boston MA
2Division of Graduate Medical Sciences, Boston University School of Medicine, Boston, MA
3Harvard Shoulder Service Harvard Medical School Boston MA
4Department of Radiology New England Baptist Hospital Boston MA
5Department of Physical Medicine and Rehabilitation Spaulding Rehabilitation Hospital and Harvard Medical School Boston MA
6Department of Physical Medicine and Rehabilitation Vanderbilt University Medical Center Nashville TN

Tóm tắt

Objective

To assess the literature on outcomes of corticosteroid injections for adhesive capsulitis, and, in particular, image‐guided corticosteroid injections.

Type

Systematic search and review.

Literature Survey

The databases used were PubMed (1966‐present), EMBASE (1947‐present), Web of Science (1900‐present), and the Cochrane Central Register of Controlled Trials. Upon reviewing full‐text articles of these studies, a total of 25 studies were identified for inclusion. The final yield included 7 prospective studies, 16 randomized trials, and 2 retrospective studies.

Methodology

This systematic review was formatted by using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Study criteria were limited to clinical trials, prospective studies, and retrospective studies that specifically evaluated intra‐articular corticosteroid injections, both alone and in combination with other treatment modalities, for shoulder adhesive capsulitis. We included studies that were not randomized control trials because our review was not a meta‐analysis. Data items extracted from each study included the following: study design, study population, mean patient age, duration of study, duration of symptoms, intervention, single or multiple injections, location of injections, control population, follow‐up duration, and outcome measurements. A percentage change in outcome measurements was calculated when corresponding data were available. Risk of bias in individual studies was assessed when appropriate.

Synthesis

All the studies involved at least 1 corticosteroid injection intended for placement in the glenohumeral joint, but only 8 studies used image guidance for all injections. Seven of these studies reported statistically significant improvements in range of motion at or before 12 weeks of follow‐up. Ninety‐two percent of all the studies documented a greater improvement in either visual analog pain scores or range of motion after corticosteroid injections in the first 1‐6 weeks compared with the control or comparison group.

Conclusions

Corticosteroid injections offer rapid pain relief in the short‐term (particularly in the first 6 weeks) for adhesive capsulitis. Long‐term outcomes seem to be similar to other treatments, including placebo. The added benefit of image‐guided corticosteroid injections in improving shoulder outcomes needs further assessment.


Tài liệu tham khảo

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Wiley

Tập 6 Số 12

1143-1156

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