Clinics in Shoulder and Elbow最新文献

{"title":"The impact of tranexamic acid on surgical efficiency and visualization in arthroscopic rotator cuff repair: a systematic review and meta-analysis.","authors":"Carlos Acosta-Olivo, Gregorio Villarreal-Villarreal, Ricardo Salinas-Garza, Victor Peña-Martínez, Francisco Arrambide-Garza, Mario Simental-Mendía","doi":"10.5397/cise.2025.00780","DOIUrl":"10.5397/cise.2025.00780","url":null,"abstract":"<p><strong>Background: </strong>Tranexamic acid (TXA) is widely used to reduce bleeding and transfusion requirements during orthopedic procedures. The objective of this review was to evaluate the efficacy of TXA in the arthroscopic repair of rotator cuff tears.</p><p><strong>Methods: </strong>This systematic review and meta-analysis focused exclusively on randomized controlled trials, sourcing data from Medline, Embase, Web of Science, Scopus, and Cochrane Central up to January 2025. This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, and evaluated parameters such as visualization in the surgical field, pain, function, total operation time, mean arterial pressure, amount of fluid lost, hospital stay, tear size, and complications.</p><p><strong>Results: </strong>Initially, 298 records were identified. After a comprehensive screening process, 12 studies involving 967 patients were selected for inclusion. Most of the included studies used a saline solution as the control, and the most common route of TXA administration was intravenous, with a dose of 1,000 mg diluted in 100 mL of solution. In the parameters evaluated, no significant differences were found favoring the use of TXA. There was limited comparability of the results reported across the included studies.</p><p><strong>Conclusions: </strong>This study finds a lack of clear evidence to support a clinical benefit of TXA in arthroscopic rotator cuff repair. Consequently, the routine use of TXA for this procedure should be reconsidered. Given its established safety profile, TXA might still have a role in specific, limited clinical situations in which its benefits could outweigh the current lack of evidence for its widespread application. Level of evidence: I.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"29 1","pages":"28-43"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain severity over duration: a new paradigm for hydrodilatation in frozen shoulder-pain, not timing, matters.","authors":"Chris Hyunchul Jo","doi":"10.5397/cise.2026.00080","DOIUrl":"10.5397/cise.2026.00080","url":null,"abstract":"","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"29 1","pages":"1-2"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence rates to the Minimum Information for Studies Evaluating Biologics in Orthopedics guidelines for clinical studies on platelet-rich plasma for the treatment of lateral epicondylitis: a systematic review.","authors":"Davis Hedbany, Bradley A Lezak, James Butler, Nathaniel P Mercer, Sebastian Krebsbach, John G Kennedy","doi":"10.5397/cise.2024.01060","DOIUrl":"10.5397/cise.2024.01060","url":null,"abstract":"<p><strong>Background: </strong>Lateral epicondylitis (LE), commonly known as tennis elbow, is a condition involving inflammation of the extensor carpi radialis brevis tendon at its attachment to the lateral epicondyle of the humerus. In recent years, platelet-rich plasma (PRP) therapy, an ortho- biologic treatment, has emerged as a promising option for the treatment of LE. Despite promising results in clinical trials, variability in PRP preparation and administration is a barrier to consistent outcomes. To address this, the Minimum Information for Studies Evaluating Biologics in Orthopedics (MIBO) guidelines were created in 2017 to establish a standardized approach for reporting findings in PRP-based studies. The objective of this study was to analyze and compare the rate of adherence of the MIBO guidelines in the use of PRP in treating LE.</p><p><strong>Methods: </strong>This systematic review evaluates the adherence of studies on PRP for LE to MIBO guidelines using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Adherence was determined by calculating the total percentage of checklist items that each study adequately and clearly reported from the 46-point checklist.</p><p><strong>Results: </strong>A total of 26 studies (954 patients) were included. Overall, only 52.2% of the 46-point MIBO checklist was reported per article on average with 0 articles displaying adherence rates of 100%. There was no significant difference in the mean adherence rates between studies prior to publication of the MIBO guidelines (45.2%) and after (53.7%).</p><p><strong>Conclusions: </strong>This review demonstrated that studies evaluating the outcomes and procedures of the use of PRP in the setting of LE have poor adherence to MIBO guidelines. There was no difference in the adherence rates in studies published before and after the creation of MIBO guidelines in 2017.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"105-114"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive review of dynamic anterior stabilization of the long head of the biceps.","authors":"Abdulhamit Misir","doi":"10.5397/cise.2025.00752","DOIUrl":"10.5397/cise.2025.00752","url":null,"abstract":"<p><p>Dynamic anterior stabilization (DAS) using the long head of the biceps tendon (LHB) is an arthroscopic option for recurrent anterior shoulder instability, especially with subcritical glenoid bone loss. This narrative review synthesizes biomechanical, technical, and clinical literature from PubMed/Medline, Embase, Cochrane (2014-2025), and Google Scholar. LHB-based DAS augments an arthroscopic Bankart repair by transferring the patient's LHB to the anterior glenoid, creating a dynamic \"hammock-sling-bumper\" effect that resists anterior translation in vulnerable positions. Contemporary techniques use minimally morbid arthroscopy with onlay or inlay fixation. Clinical series report low recurrence (0%-13%) at 1-5 years. Functional outcomes improve substantially: Rowe scores typically rise from 21-36 preoperatively to 90-95 postoperatively, American Shoulder and Elbow Surgeons scores exceed 90, and Western Ontario Shoulder Instability Index improves by roughly 959 points. Return-to-sport rates reach 85%-95%, with range of motion generally comparable to standard Bankart repairs. In patients with subcritical bone loss (10%-20% of glenoid width), DAS appears to enhance stability versus isolated soft-tissue repair while avoiding the complication profile of bone-block procedures (e.g., Latarjet). Suggested indications include recurrent instability with subcritical bone loss, failed prior soft-tissue repair, young high-demand athletes, and concomitant superior labrum anterior to posterior lesions. Contraindications and optimal thresholds for bone loss require clarification. Evidence remains limited by nonrandomized designs and short follow-up. Long-term outcomes beyond five years and high-quality comparative or randomized trials are needed to define durability, refine indications, and position LHB-based DAS within the broader algorithm for anterior shoulder instability management.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"141-160"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and radiological outcomes after arthroscopic-assisted lower trapezius tendon transfer for isolated irreparable infraspinatus tear.","authors":"Chang Hee Baek, Bo Taek Kim, Jung Gon Kim, Chaemoon Lim, Luis Alfredo Miranda, Jean Kany","doi":"10.5397/cise.2024.00864","DOIUrl":"10.5397/cise.2024.00864","url":null,"abstract":"<p><strong>Background: </strong>Isolated infraspinatus tears are rare and traditional arthroscopic repairs often result in unsatisfactory outcomes. This study evaluates the clinical and radiological outcomes of arthroscopically-assisted lower trapezius tendon (aLTT) transfer in patients with isolated irreparable infraspinatus tears.</p><p><strong>Methods: </strong>This single-center retrospective study reviewed patients who underwent aLTT transfer for irreparable infraspinatus tears with no advanced glenohumeral arthritis. Clinical assessment included visual analog scale (VAS), Constant score, American Shoulder and Elbow Surgeons (ASES) score, and Single Assessment Numeric Evaluation (SANE). Shoulder range of motion was also evaluated. Radiographic evaluation included postoperative magnetic resonance imaging used to evaluate tendon integrity at final follow-up. Two patients were excluded due to loss to follow-up or incomplete data.</p><p><strong>Results: </strong>Six patients were included, with a mean age of 60.7±4.1 years and a mean follow-up duration of 36.7±19.8 months (range, 24-75 months). At the final follow-up, VAS pain scores had improved from 6.0±1.4 to 1.7±0.8 (P<0.05). Functional scores had also improved: Constant score, from 51.5±5.6 to 72.0±6.4; ASES, from 60.5±4.5 to 82.0±6.3; and SANE, from 48.0±6.7 to 79.1±8.0 (P<0.05). Range of motion (ROM) improved in forward elevation (115°±12° to 170°±9°), abduction (95°±15° to 143°±16°), and external rotation at side (22°±11° to 51°±11°) (P<0.05). No progression of glenohumeral arthritis or tendon retears were seen on final follow-up.</p><p><strong>Conclusions: </strong>aLTT transfer significantly reduces pain, improves shoulder function, and restores ROM in patients with isolated irreparable infraspinatus tears. These findings suggest that aLTT transfer is an effective treatment option for this challenging condition. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"29 1","pages":"3-9"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of preoperative elbow dysfunction on health-related quality of life: an EQ-5D analysis in patients awaiting surgery.","authors":"Tamara Babasiz, Nadine Ott, Michael Sarter, Felix Krane, Lars P Müller, Tim Leschinger","doi":"10.5397/cise.2025.00962","DOIUrl":"10.5397/cise.2025.00962","url":null,"abstract":"<p><strong>Background: </strong>Elbow dysfunction can impair daily activities and reduce health-related quality of life (HRQoL). This study used the EuroQol five dimensions instrument (EQ-5D) alongside functional scores and treatment priorities to assess HRQoL in patients awaiting elective elbow surgery.</p><p><strong>Methods: </strong>In this prospective study, patients scheduled for elbow surgery from December 2024 onward were enrolled and categorized as having osteoarthritis, stiffness, or instability. HRQoL was measured using the EQ-5D. Multivariable regression was performed with EQ-5D as the dependent variable and waiting time, age, sex, and diagnosis as predictors. Functional outcomes were assessed with the Mayo Elbow Performance Score (MEPS) and Quick Disabilities of the Arm, Shoulder and Hand (qDASH). Patients also indicated whether they prioritized pain relief or improved mobility.</p><p><strong>Results: </strong>Overall, 102 patients were included. The mean waiting time was 204±115 days, and the overall EQ-5D index was 0.67±0.06. Patients with osteoarthritis had the lowest EQ-5D index (0.60±0.29), highest pain levels (2.32±0.48), and greatest depression scores (1.97±0.75). They also showed the lowest MEPS and highest qDASH, with MEPS significantly lower than in patients with instability (P=0.016). The multivariable regression suggested non-significant trends toward lower EQ-5D with longer waiting times (β=-0.0001, P=0.663) and older age (β=0.002, P=0.306). Osteoarthritis patients prioritized pain relief (P=0.026), and stiffness patients prioritized mobility (P=0.021).</p><p><strong>Conclusions: </strong>Although longer waiting times and older age showed non-significant trends toward lower HRQoL, osteoarthritis patients were most affected, with the lowest EQ-5D (0.60) and significantly worse MEPS (P=0.016) than in the other groups. Future studies should test whether preoperative pain or psychological support can mitigate HRQoL decline. Level of evidence: II.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"29 1","pages":"44-51"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of internal impingement in overhead athletes: a systematic review.","authors":"Dimitris Challoumas, Cheryl Loh, Nachika Ibekwe, Tze Ching Christy Leung, Neal Millar","doi":"10.5397/cise.2025.01123","DOIUrl":"10.5397/cise.2025.01123","url":null,"abstract":"<p><strong>Background: </strong>We aimed to review all published evidence on the surgical management of internal impingement and associated conditions in athletes of overhead sports.</p><p><strong>Methods: </strong>Our search included studies reporting outcomes of any surgical intervention on shoulder internal impingement and its sequelae in overhead athletes. The primary outcome was return to sport at pre-injury level or higher in the main text (RTS+). Secondary outcomes included return to sport at any level (RTS), shoulder function, and complications. No quantitative analyses were possible due to the nature of the evidence included.</p><p><strong>Results: </strong>Forty-two observational studies were eligible. They included 1,420 overhead athletes with a mean age of 27.3 years. RTS+ across all surgical procedures ranged from 25% to 94%. In patients treated with debridement of articular-sided partial-thickness rotator cuff tears, the RTS+ ranged from 50% to 85%, and in those who underwent posterior glenoidplasty for glenoid spurs, it ranged from 55% to 63.6%. Comparative studies for superior labrum anterior to posterior (SLAP) tears demonstrated similar RTS+ after open subpectoral tenodesis and arthroscopic SLAP repair. RTS+ after the two procedures in all observational studies ranged from 35% to 100% and 54.2% to 100%, respectively. RTS+ after capsulorrhaphy, when performed concomitantly with other procedures, ranged from 25% to 93%.</p><p><strong>Conclusions: </strong>Outcomes associated with the surgical management of internal impingement are variable. Surgical decision-making should prioritize patient-specific factors following unsuccessful conservative management. We provide surgical recommendations and considerations.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"115-133"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of electromyography biofeedback training on scapular kinematics and muscle activation in patients with scapular dyskinesis: a systematic review and meta-analysis.","authors":"Héctor Gutiérrez-Espinoza, Guillermo Méndez-Rebolledo, Iván Cuyul-Vásquez, Felipe Araya-Quintanilla, Enrique Lluch","doi":"10.5397/cise.2025.01151","DOIUrl":"10.5397/cise.2025.01151","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the effectiveness of electromyography (EMG) biofeedback training on scapular kinematics and/or muscle activation in patients with scapular dyskinesis (SD) associated with subacromial impingement syndrome (SIS).</p><p><strong>Methods: </strong>An electronic search was conducted in the Medline, Embase, Scopus, Web of Science, CINAHL, SPORTDiscus, LILACS, CENTRAL, and PEDro databases. Eligibility criteria comprised randomized clinical trials investigating the effects of adding EMG biofeedback training to scapular-focused exercises on scapular kinematics and/or muscle activation in patients with SD associated with SIS. Data were pooled using a Hartung-Knapp-Sidik-Jonkman random-effects method or Mantel-Haenszel fixed-effects model. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE).</p><p><strong>Results: </strong>Four trials met the eligibility criteria. The mean difference (MD) for upward rotation was 1.13° (P=0.07), and that for downward rotation was 1.2° (P=0.08). The MDs for muscle activation of the lower trapezius during scapular plane elevation and descending movements were 7.22% (P=0.010) and 2.26% (P<0.001), respectively. The MDs for the muscle balance ratios of the upper/lower trapezius and upper trapezius/serratus anterior were 0.11% (P=0.95) and 0.15% (P=0.04), respectively. All differences favored the EMG biofeedback plus scapular-focused exercises group.</p><p><strong>Conclusions: </strong>In the short-term, adding EMG biofeedback training to scapular-focused exercises resulted in significant differences only in lower trapezius activity. Conversely, the results were inconclusive regarding improvements in scapular kinematics and changes in the activation of other scapular muscles. The quality of evidence ranged from very low to high according to GRADE rating, suggesting that the effect of EMG biofeedback might not be captured in this study. Level of evidence: I.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"82-95"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating large language model responses to patient questions on ulnar collateral ligament repair.","authors":"Benjamin W King, Evan P Bailey, Eric Warren, Grant Garrigues, Kyle Hammond, Richard M Danilkowicz","doi":"10.5397/cise.2025.01214","DOIUrl":"10.5397/cise.2025.01214","url":null,"abstract":"<p><strong>Background: </strong>The incidence of ulnar collateral ligament (UCL) repair continues to increase, so evaluating the accuracy and readability of information about this procedure that is produced by artificial intelligence (AI) models is important. This study assesses AI-generated responses to common patient questions about UCL repair.</p><p><strong>Methods: </strong>Twenty patient questions frequently encountered in clinical practice were submitted to ChatGPT, Gemini, and Grok. Three fellowship- trained orthopedic surgeons independently rated answer accuracy using the ChatGPT Response Rating System (CRRS) and AI Response Metric (AIRM), which assign scores from 1-5, with lower scores indicating better accuracy. Responses with CRRS >2 were classified as requiring more than minimal clarification. Readability was evaluated using the Flesch-Kincaid Reading Ease (FKRE) and Grade Level (FKGL) metrics. Responses with an FKGL >6 exceeded the American Medical Association (AMA) and National Institutes of Health (NIH) recommended 6th grade reading level for patient education materials.</p><p><strong>Results: </strong>More than minimal clarification was required for 15% (3/20) of ChatGPT, 5% (1/20) of Gemini, and 40% (8/20) of Grok responses. Gemini (CRRS, 1.5±0.5; AIRM, 1.6±0.5) demonstrated significantly better accuracy than ChatGPT (CRRS, 2.0±0.4; P=0.0002; AIRM, 2.2±0.5; P=0.0001) and Grok (CRRS, 2.1±0.7; P=0.005; AIRM, 2.4±0.8; P=0.002). All responses exceeded the AMA/NIH 6th grade reading level threshold (FKGL >6). Gemini produced the highest FKGL (16.2±2.2), significantly higher than ChatGPT (14.4±1.6, P=0.005) and Grok (14.6±1.7, P=0.017). FKRE did not differ significantly among models (P=0.14).</p><p><strong>Conclusions: </strong>AI models generated generally accurate information about UCL repair but at reading levels far above the AMA/NIH recommendations. In this study, Gemini was the most accurate model and produced the least readable content. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"29 1","pages":"73-81"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with shoulder function following ultrasound-guided hydrodilatation in patients with frozen shoulder: a prospective observational study.","authors":"Paramee Trakulkajornsak, Timporn Vitoonpong, Sarissa Rangkla, Chernkhuan Stonsaovapak, Natthiya Tantisiriwat","doi":"10.5397/cise.2025.00773","DOIUrl":"10.5397/cise.2025.00773","url":null,"abstract":"<p><strong>Background: </strong>Existing research on the influence of symptom duration on the outcomes of ultrasound-guided shoulder hydrodilatation for frozen shoulder remains limited. This prospective analytical study aims to investigate the associations between symptom duration and other potential factors and shoulder function following ultrasound-guided shoulder hydrodilatation.</p><p><strong>Methods: </strong>This study was conducted at the Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital, and involved patients with frozen shoulder who underwent ultrasound-guided shoulder hydrodilatation. Using convenience sampling, 72 participants were recruited, and 36 were classified into the early hydrodilatation group and 36 into the late hydrodilatation group. Outcome measures were the Oxford Shoulder Score (OSS), visual analog scale (VAS), and shoulder range of motion (ROM), which were assessed both before and 6 weeks after the hydrodilatation procedure.</p><p><strong>Results: </strong>Duration of symptoms, age, sex, history of diabetes mellitus, physiotherapy, and baseline shoulder ROM did not exhibit any association with OSS changes. However, a high VAS score at baseline was associated significantly with improved shoulder function following ultrasound- guided shoulder hydrodilatation (P=0.006).</p><p><strong>Conclusions: </strong>There was no association between the duration of symptoms and enhanced shoulder function after ultrasound-guided shoulder hydrodilatation in short-term assessments. Patients with higher baseline shoulder pain severity tended to experience greater improvements in shoulder function compared to those with milder pain levels. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"20-27"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}