TREATMENT OF ADHESIVE CAPSULITIS WITH THE TRIPLE PROCEDURE: INTRA-ARTICULAR INJECTION WITH CORTICOSTEROIDS, HYDRODILATION AND SHOULDER MANIPULATION UNDER SEDATION.

IF 0.5 4区医学 Q4 ORTHOPEDICS

Acta Ortopedica Brasileira Pub Date : 2025-01-10 eCollection Date: 2024-01-01 DOI:10.1590/1413-785220243206e281046

Mauro Emilio Conforto Gracitelli, Jorge Henrique Assunção, Micael de Mesquita Paiva, Fernando Brandão de Andrade E Silva, Arnaldo Amado Ferreira, Eduardo Angeli Malavolta

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引用次数: 0

Abstract

Objective: There are several conservative treatment options for adhesive capsulitis (AC), but no previous study combines hydrodilation, corticosteroid injection and joint manipulation under sedation (triple procedure), followed by daily home exercises.

Methods: Patients included were evaluated before the procedure, at 30 days, 3, 6 and 12 months after treatment in prospective cohort. The outcomes used were the ASES, UCLA, SANE, VAS scales and passive range of motion (ROM).

Results: 65 shoulders of 63 patients were included. The mean ASES score progressed from 37.7 ± 17.9 to 94.1 ± 10.3 at 12 months after the procedure (p < 0.001). The mean UCLA went from 15.9 ± 5 to 33.2 ± 2.8 and SANE from 50.4 ± 18.3 to 94.3±9.0. At 12 months, the passive elevation improved from 114°±24° to 176° ± 6°, external rotation in neutral from 29° ± 17° to 72° ± 11° and internal rotation in neutral from 18.6 ± 3.6 points to 9.4 ± 2.4 points. No patient presented a fracture after manipulation.

Conclusions: Treatment with the triple procedure resulted in a statistically and clinically relevant improvement in functional results and gains in shoulder range of motion, with no reports of complications. Level of evidence IV, Prospective study.

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治疗粘连性囊炎的三联手术：关节内注射皮质类固醇、水扩张和镇静下的肩部操作。

目的：粘连性囊炎（AC）有几种保守治疗方案，但之前没有研究将水扩张、皮质类固醇注射和镇静下的关节操作（三联手术）结合起来，然后每天在家锻炼。方法：纳入的患者在术前、治疗后30天、3个月、6个月和12个月进行前瞻性队列评估。使用的结果是as、UCLA、SANE、VAS量表和被动活动度（ROM）。结果：纳入63例患者65肩。术后12个月，平均as评分由37.7±17.9分上升至94.1±10.3分（p < 0.001）。平均UCLA由15.9±5上升至33.2±2.8，SANE由50.4±18.3上升至94.3±9.0。12个月时，被动俯仰从114°±24°提高到176°±6°，中立位外旋从29°±17°提高到72°±11°，中立位内旋从18.6±3.6点提高到9.4±2.4点。操作后无患者出现骨折。结论：三联手术治疗在功能结果和肩部活动范围方面有统计学和临床相关的改善，无并发症报告。证据等级IV，前瞻性研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ortopedica Brasileira Orthopedics-

CiteScore

0.90

自引率

14.30%

发文量

审稿时长

25 weeks

期刊介绍： A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.