Direct Coracohumeral Ligament Steroid Injection
Conditions
Keywords
adhesive capsulitis
Brief summary
Steroid injections are widely utilized to reduce inflammation and fibrosis in patients with the frozen shoulder. In this study, investigators will compare intra-articular steroid injections with direct coracohumeral ligament steroid injection to conventional intra-articular steroid injection. Investigators will measure the primary outcome as shoulder function improvement and secondary outcomes as ROM, pain scale and stiffness of coracohumeral ligament under elastogram.
Detailed description
Adhesive capsulitis of the shoulder, also known as the frozen shoulder, often leads to severe pain and shoulder range of motion limitation. Steroid injections are widely utilized to reduce inflammation and fibrosis. The thickening of the coracohumeral ligament was thought to play an important role in the pathogenesis of frozen shoulder, resulting in limited external rotation of the shoulder. While the elastogram of coracohumeral ligament will significantly increase stiffness under the shear-wave ultrasound (shear-wave elastography). Therefore, in this study, investigators will compare intra-articular steroid injections with direct coracohumeral ligament steroid injection to conventional intra-articular steroid injection. Investigators will measure the primary outcome as shoulder function improvement and secondary outcomes as ROM, pain scale and stiffness of coracohumeral ligament under elastogram. (the patient will not have additional risk of injection under ultrasound guidance)
Interventions
PROCEDUREIntraarticular triamcinolone injection
triamcinolone 10mg/mL
PROCEDUREIntraarticular Xylocaine injection
Xylocaine 1% 4ml
PROCEDURECoracohumeral ligament triamcinolone injection
triamcinolone 10mg/mL
PROCEDUREPhysiotherapy
Sponsors
National Taiwan University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
A.Inclusion criteria： 1. Age 20-80 years old 2. Unilateral shoulder pain more than 3 months 3. At least one shoulder ROM limitation in three dimensions which decreased over 50% (Abduction, Flexion, External rotation) 4. Visual analog scale more than 30 (total 100) 5. No fracture or subluxation or arthritis in shoulder Xray. B.
Exclusion criteria
： 1. History of shoulder or chest surgery 2. History of shoulder trauma in 2 recent years 3. Ever receiving shoulder joint injection in recent 3 months 4. With cervical radiculopathy or any central CNS disorders 5. With osteoarthritis or rheumatic arthritis of shoulder 6. Diagnosed as rotator cuff tear, tendon calcification or bursitis 7. Systemic diseases including diabetes or thyroid disorder 8. Allergy history of steroid
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Shoulder function (The Disabilities of the Arm, Shoulder and Hand Score, QuickDash) improvement | 2 years | shoulder function improvement (The Disabilities of the Arm, Shoulder and Hand Score, QuickDash), score 0-100 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change of Visual analogue scale | 2 years | Visual analogue scale: scale 0-10 |
| Shoulder range of motion improvement | 2 years | Range of motion improvement: flexion, abduction, external rotation (degree) |
| Stiffness of coracohumeral ligament under elastogram (KPa) | 2 years | — |
Countries
Taiwan
Contacts
Primary ContactChueh-Hung Wu
Outcome results
None listed