Glenohumeral Arthritis, Rotator Cuff Arthropathy
Conditions
Keywords
osteoarthritis, glenohumeral arthritis, rotator cuff arthropathy, corticosteroid injection, suprascapular nerve block
Brief summary
The purpose of this study is to evaluate conservative pain relief measures for patients suffering from glenohumeral arthritis or rotator cuff arthropathy. Conservative management of osteoarthritis is often first line treatment, and while a corticosteroid injection is frequently used, suprascapular nerve blocks have not often been described as an analgesic option in this population.
Interventions
OTHERintraarticular corticosteroid injection (IACI)
The patient will be in a seated position. Correct patient, laterality, and procedure will be performed during the timeout. Ultrasound guidance will be used to identify the glenohumeral joint. The injection site will then be disinfected with an alcohol wipe. A 21, 22, or 23-gauge needle (depending on provider preference) will be advanced into the glenohumeral joint under direct ultrasound visualization. After entry into the glenohumeral joint, a negative aspiration will be performed. At that time, up to 1 mL of 40mg/mL methylprednisolone acetate will be injected be injected into the joint space.
The patient will be in a seated position. Correct patient, laterality, and procedure will be performed during the timeout. Ultrasound guidance will be used to identify the suprascapular nerve in its path at the suprascapular notch. After disinfection of the injection site with alcohol, anatomic landmarks for SSNB as described by Dangoisse et al. \[10\] will be marked with a marking pen. Ultrasound will be utilized to guide the tip of a 21, 22, or 23 gauge (depending on provider preference) needle to the floor of the suprascapular fossa while avoiding neurovascular structures. At that time, a mixture of up to 10 mL of 0.5% bupivacaine and 20 mg triamcinolone will be slowly injected to fill the fascial contents of the suprascapular fossa under direct ultrasound guidance.
Sponsors
University of Minnesota
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Intervention model description
Two study arms, with each arm receiving one of two interventions: corticosteroid shoulder injection or suprascapular nerve block
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* diagnosis of glenohumeral osteoarthritis, rheumatoid arthritis, or rotator cuff arthropathy who are being offered injection
Exclusion criteria
* uncontrolled diabetes (patients will be excluded if no HbA1c within a year or if it is 8 or greater * known allergy to steroid or anesthetic * pregnant women * prisoners * patients with diminished capacity to consent to participation * children under 18 years of age * non-English speakers
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| change in visual analog scale (VAS) for pain | preintervention, 24 hours, 3 days, 1 month, and 3 months postintervention | a validated continuous scale assessment for pain |
| single assessment numerical evaluation (SANE) of the shoulder | preintervention, 24 hours, 3 days, 1 month, and 3 months postintervention | a validated tool providing a numerical score from 0-100 that assess shoulder function as subjectively reported by the subject. A higher score indicates superior shoulder function. |
| Oxford shoulder score (OSS) | preintervention, 24 hours, 3 days, 1 month, and 3 months postintervention | a validated patient-reported outcome measure used to assess shoulder pain and functional disability. Possible scores range from 0-48 with higher scores indicating superior better shoulder function. |
| American shoulder and elbow surgeons (ASES) score | preintervention, 24 hours, 3 days, 1 month, and 3 months postintervention | a validated survey with possible scores from 0-100 that assesses shoulder function as reported by the subject. A higher score indicates superior shoulder function. |
Countries
United States
Contacts
Primary ContactAllison Rao
Outcome results
None listed