Shoulder adhesive capsulitis: manipulation and arthroscopic arthrolysis or intra-articular steroid injections?
Shoulder adhesive capsulitis: manipulation and arthroscopic arthrolysis or intra-articular steroid injections?
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DOI：
10.1007/s00264-011-1330-7
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发表时间：
2012-01-01
影响因子：
2.7
通讯作者：
Ferretti, Andrea
中科院分区：
文献类型：
--
作者：
De Carli, Angelo;Vadala, Antonio;Ferretti, Andrea
本研究的目的是比较肩关节手法和关节镜下关节松解术与盂肱类固醇注射治疗特发性粘连性肩关节囊炎的疗效。在这项前瞻性研究中，我们将患者随机分为A组（23例，肩关节手法和关节镜下关节松解术）和B组（21例，盂肱类固醇注射）。在3周、6周和12周以及6个月和12个月时，使用Constant和Murley、ASES、UCLA和SST评估量表对患者进行随访。两组患者最后随访时的活动度均满意：A组ABD从60 A °增加到154 A °，ER从20 A °增加到40 A °，FF从75 A °增加到174 A °; B组ABD从76 A度上升到145 A度，ER从20 A度上升到35 A度，FF从115 A度上升到164 A度。两组在最终随访时进行的所有评估量表均显著增加。然而，虽然A组患者在6周随访时已达到显著改善，（p < 0.03），B组仅在12周随访时发生两种治疗方法均能有效改善患者的最终关节活动度;然而，虽然A组患者在6周随访时完成了他们的目标，但B组在12周随访时获得了相同的结果。
The aim of this study was to compare shoulder manipulation and arthroscopic arthrolysis with glenohumeral steroid injections in patients affected by idiopathic adhesive shoulder capsulitis.In this prospective study we randomly assigned patients to enter group A (23 patients, shoulder manipulation and arthroscopic arthrolysis) and group B (21 patients, glenohumeral steroid injections). Patients were followed-up at three, six and 12 weeks, and at six and 12 months with the Constant and Murley, ASES, UCLA and SST evaluation scales. Moreover, passive forward flexion, abduction, and internal and external rotations were recorded.Range of motion showed satisfactory results in both groups at final follow-up: in group A the mean ABD increased from 60A degrees to 154A degrees, ER from 20A degrees to 40A degrees, and FF from 75A degrees to 174A degrees; in group B, ABD raised from 76A degrees to 145A degrees, ER from 20A degrees to 35A degrees, and FF from 115A degrees to 164A degrees. All the evaluation scales performed increased significantly at final follow-up in both groups. However, while patients of group A had already reached significant improvement at the six-week follow-up (p < 0.03), in group B this happened only at the 12 week follow-up (p < 0.03).Both types of treatment were effective in improving final range of motion; however, while patients of group A accomplished their goal by the six-week follow-up, in group B the same result was obtained at the 12-week follow-up.