{"title":"关节内透明质酸盐注射与皮质类固醇注射对粘连性囊炎疗效的比较：系统回顾与元分析》。","authors":"Kyeong Eun Uhm, Min Cheol Chang","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Adhesive capsulitis of the shoulder causes inflammation and adhesions in the shoulder joint capsule, leading to pain and limited range of motion (ROM). Intraarticular corticosteroid (CS) and hyaluronic acid (HA) injections are common therapeutic options for adhesive capsulitis, but their comparative effectiveness remains unclear.</p><p><strong>Objectives: </strong>To provide a robust comparison of the outcomes of HA and CS, we conducted a meta-analysis of relevant previous studies that examined the therapeutic effects of intraarticular HA and CS injections in patients with adhesive capsulitis.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>This meta-analysis of randomized controlled trials compared the effectiveness of intraarticular HA and CS injections. Of the 10,205 articles, 7 met our predetermined criteria and were included in the analysis.</p><p><strong>Results: </strong>Patients who received CS injections demonstrated superior pain reduction and functional improvement at 2-4 weeks after injection to those who received HA injections. Nevertheless, comparable outcomes were observed between the 2 groups at 6 and 12 weeks. The active or passive range of motion of the shoulder joint was not significantly different between patients who received HA injections and those who received CS injections.</p><p><strong>Limitations: </strong>The meta-analysis included only a small number of studies, and the number of HA injections examined in those studies varied from one to 3 at a time, whereas an CS injection was performed only once in most of the included studies.</p><p><strong>Conclusions: </strong>The administration of intraarticular HA injection emerges as a commendable therapeutic option for patients with adhesive capsulitis, particularly for those requiring repetitive injections or at risk of developing side effects from injections of CS. Although intraarticular CS injections offer accelerated short-term (2-4 weeks) pain relief and functional improvement, comparable effects were observed within 6 and 12 weeks after intraarticular HA and CS injections.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of Effectiveness of Intraarticular Hyaluronate and Corticosteroid injections in Adhesive Capsulitis: A Systematic Review and Meta-analysis.\",\"authors\":\"Kyeong Eun Uhm, Min Cheol Chang\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Adhesive capsulitis of the shoulder causes inflammation and adhesions in the shoulder joint capsule, leading to pain and limited range of motion (ROM). Intraarticular corticosteroid (CS) and hyaluronic acid (HA) injections are common therapeutic options for adhesive capsulitis, but their comparative effectiveness remains unclear.</p><p><strong>Objectives: </strong>To provide a robust comparison of the outcomes of HA and CS, we conducted a meta-analysis of relevant previous studies that examined the therapeutic effects of intraarticular HA and CS injections in patients with adhesive capsulitis.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>This meta-analysis of randomized controlled trials compared the effectiveness of intraarticular HA and CS injections. Of the 10,205 articles, 7 met our predetermined criteria and were included in the analysis.</p><p><strong>Results: </strong>Patients who received CS injections demonstrated superior pain reduction and functional improvement at 2-4 weeks after injection to those who received HA injections. Nevertheless, comparable outcomes were observed between the 2 groups at 6 and 12 weeks. The active or passive range of motion of the shoulder joint was not significantly different between patients who received HA injections and those who received CS injections.</p><p><strong>Limitations: </strong>The meta-analysis included only a small number of studies, and the number of HA injections examined in those studies varied from one to 3 at a time, whereas an CS injection was performed only once in most of the included studies.</p><p><strong>Conclusions: </strong>The administration of intraarticular HA injection emerges as a commendable therapeutic option for patients with adhesive capsulitis, particularly for those requiring repetitive injections or at risk of developing side effects from injections of CS. Although intraarticular CS injections offer accelerated short-term (2-4 weeks) pain relief and functional improvement, comparable effects were observed within 6 and 12 weeks after intraarticular HA and CS injections.</p>\",\"PeriodicalId\":19841,\"journal\":{\"name\":\"Pain physician\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pain physician\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pain physician","FirstCategoryId":"3","ListUrlMain":"","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：肩关节粘连性囊炎会引起肩关节囊发炎和粘连，导致疼痛和活动范围（ROM）受限。关节腔内皮质类固醇（CS）和透明质酸（HA）注射是治疗粘连性肩关节囊炎的常见方法，但它们的疗效对比仍不明确：为了对HA和CS的疗效进行有力的比较，我们对以往研究粘连性关节囊炎患者关节内注射HA和CS疗效的相关研究进行了荟萃分析：研究设计：系统回顾和荟萃分析：这项随机对照试验荟萃分析比较了关节内注射HA和CS的疗效。在10205篇文章中，有7篇符合我们预先设定的标准，被纳入分析：结果：与接受 HA 注射的患者相比，接受 CS 注射的患者在注射后 2-4 周疼痛减轻和功能改善的效果更好。尽管如此，两组患者在 6 周和 12 周后的疗效相当。接受HA注射和CS注射的患者肩关节的主动或被动活动范围没有明显差异：局限性：该荟萃分析只纳入了少量研究，这些研究中HA注射的次数从一次1次到3次不等，而大部分纳入的研究中CS注射只进行了一次：结论：对于粘连性关节囊炎患者，尤其是需要重复注射或有注射 CS 副作用风险的患者来说，关节内注射 HA 是一种值得称赞的治疗方法。虽然关节内 CS 注射可在短期内（2-4 周）加速缓解疼痛和改善功能，但在关节内注射 HA 和 CS 后 6 周和 12 周内观察到的效果相当。
Comparison of Effectiveness of Intraarticular Hyaluronate and Corticosteroid injections in Adhesive Capsulitis: A Systematic Review and Meta-analysis.
Background: Adhesive capsulitis of the shoulder causes inflammation and adhesions in the shoulder joint capsule, leading to pain and limited range of motion (ROM). Intraarticular corticosteroid (CS) and hyaluronic acid (HA) injections are common therapeutic options for adhesive capsulitis, but their comparative effectiveness remains unclear.
Objectives: To provide a robust comparison of the outcomes of HA and CS, we conducted a meta-analysis of relevant previous studies that examined the therapeutic effects of intraarticular HA and CS injections in patients with adhesive capsulitis.
Study design: Systematic review and meta-analysis.
Methods: This meta-analysis of randomized controlled trials compared the effectiveness of intraarticular HA and CS injections. Of the 10,205 articles, 7 met our predetermined criteria and were included in the analysis.
Results: Patients who received CS injections demonstrated superior pain reduction and functional improvement at 2-4 weeks after injection to those who received HA injections. Nevertheless, comparable outcomes were observed between the 2 groups at 6 and 12 weeks. The active or passive range of motion of the shoulder joint was not significantly different between patients who received HA injections and those who received CS injections.
Limitations: The meta-analysis included only a small number of studies, and the number of HA injections examined in those studies varied from one to 3 at a time, whereas an CS injection was performed only once in most of the included studies.
Conclusions: The administration of intraarticular HA injection emerges as a commendable therapeutic option for patients with adhesive capsulitis, particularly for those requiring repetitive injections or at risk of developing side effects from injections of CS. Although intraarticular CS injections offer accelerated short-term (2-4 weeks) pain relief and functional improvement, comparable effects were observed within 6 and 12 weeks after intraarticular HA and CS injections.
期刊介绍：
Pain Physician Journal is the official publication of the American Society of Interventional Pain Physicians (ASIPP). The open access journal is published 6 times a year.
Pain Physician Journal is a peer-reviewed, multi-disciplinary, open access journal written by and directed to an audience of interventional pain physicians, clinicians and basic scientists with an interest in interventional pain management and pain medicine.
Pain Physician Journal presents the latest studies, research, and information vital to those in the emerging specialty of interventional pain management – and critical to the people they serve.
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