| Treatment of Adhesive Capsulitis with Steroid Injection Followed by Hyaluronic Acid Injection. |
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Kim, Chul , Park, Yongbum , Youn, Jo Eun , Kim, Duk You |
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Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Korea. swc328@naver.com |
| 유착성 견관절염 환자에서 하이알루론산과 스테로이드 병용요법의 효과 |
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김철, 박용범, 윤조은, 김덕유 |
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인제대학교 의과대학 상계백병원 재활의학교실 |
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| Abstract |
Objective
To investigate the effects of sono-guided intraarticular steroid injection followed by sodium hyaluronate injection weekly for 2 weeks on adhesive capsulitis of the shoulder
Method
In this prospective randomized controlled trial, 16 patients (group A) were treated with intraarticular injection with a mixture of 0.5% lidocaine 9 ml and triamcinolone 40 mg once a week for 3 weeks, and 13 patients (group B) were treated with intraarticular injection with a mixture of 0.5% lidocaine 9 ml and triamcinolone 40 mg for the first week, and subsequently a mixture of 0.5% lidocaine 8 ml and sodium hyaluronate 2 ml once a week for the next 3 weeks. A self exercise program was instructed for all subjects. The effects were assessed using visual numeric scale (VNS), shoulder pain and disability index (SPADI), and range of shoulder motion (flexion, abduction, internal rotation. external rotation, and extension) at study entry, every week until 2 weeks have passed after the last injection.
Results
The VNS, SPADI, and range of shoulder motion improved 1 week after 1st injection and continued to improve until 2 weeks after last injection in both two groups. There were no difference in changes of VNS and SPADI between these two groups, but range of shoulder motion especially in passive and active internal rotation of patients in group A improved more than those in group B.
Conclusion
Steroid injection combined with hyaluronic acid injection has comparable effects with triamcinolone for treatment of adhesive capsulitis of the shoulder. Sono-guided intraarticular injection of steroid combined with hyaluronic acid can substitute for intraarticular injection of triamcinolone and be useful especially for patients susceptible to adverse effects of steroid injection. (J Korean Acad Rehab Med 2010; 34: 310-315) |
| Key Words:
Adhesive capsulitis, Sodium hyaluronate, Triamcinolone |
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