Nghiên cứu hiệu quả điều trị bệnh đông cứng khớp vai bằng phương pháp tiêm nong khớp vai dưới hướng dẫn của DSA

SUMMARY

Objective: The objective was to explore the efectiveness of fluoroscopic-guided hydrodilatation of glenohumeral joint for the treatment of frozen shoulder

Materials and Methods: The prospective study 38 shoulders with primary adhesive capsulitis were treated with hydrodilatation between August 2017 and July 2020 in Radiology Centre- Bach Mai Hospital. The patient were hydrodilatation with corticosteroid injection performed via an anterior approach under fluoroscopy. Patients were followed up at baseline and at 2 and 4 weeks postintervention with Shoulder Pain and Disability Index (SPADI) scores, VAS scores, and ROM in abduction, forward flexion, external rotation.

Results: A total of 38 consecutive patients with frozen shoulder underwent a distension arthrogram. There were 20 females and 18 males with a mean age of 59,6 (range : 43-91). The mean visual analogue pain score pre-distension was 6,1, two weeks and four weeks post-distension the mean score had significantly improved to 4,1 and 2,9. Mean baseline SPADI score for the patients pre-distension was 65, two weeks and four weeks post-distension the mean score had significantly improved to 45 and 32. Flexion improved from a mean of 76 degrees pre-distension with 106 degrees at 2 weeks and with 131 degrees at 4 weeks. Abduction improved from a mean of 75 degrees pre-distension with 107 degrees at 2 weeks and with 133 degrees at 4 weeks. External rotation improved from 20 degrees pre-distension with 36 degrees at 2 weeks and 53 degrees at 4 weeks. The patients receiving hydrodilatation demonstrated significant improvement in VAS scores and ROM in flexion, abduction, and external rotation at 8 weeks. No patient suffered any significant complication from hydrodilatation and, in particular, there were no intra-articular infections.

Conclusion: Review of the literature and the results presented here indicate that arthrographic capsular distension progressing using fluid containing cortisone is a fairly effective treatment for adhesive capsulitis. Distension arthrography seems to he a promising treatment for adhesive capsulitis. Arthrographic shoulder capsule distension was performed through an anterior-lateral approach under fluoroscopic guidance is accurate, reliable and minimally invasive.

Keyword: Hydrodilatation, adhesive capsulitis