• 제목/요약/키워드: L-shoulder

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Can platelet-rich plasma injections provide better pain relief and functional outcomes in persons with common shoulder diseases: a meta-analysis of randomized controlled trials

  • Barman, Apurba;Mishra, Archana;Maiti, Rituparna;Sahoo, Jagannatha;Thakur, Kaustav Basu;Sasidharan, Sreeja Kamala
    • Clinics in Shoulder and Elbow
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    • v.25 no.1
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    • pp.73-89
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    • 2022
  • Background: To evaluate the efficacy of autologous platelet-rich plasma (PRP) injections in the treatment of common shoulder diseases. Methods: The PubMed, Medline, and Central databases and trial registries were searched from their inception to October 2020 for randomized controlled trials of autologous PRP injections for shoulder diseases versus placebo or any control intervention. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed in the selection, analysis, and reporting of findings. The primary outcome was pain intensity (visual analog scale), and secondary outcomes were changes in function and quality of life (QoL). Results: A total of 17 randomized controlled trials of PRP versus control were analyzed. From 8-12 weeks to ≥1 year, PRP injections were associated with better pain relief and functional outcomes than control interventions. PRP injections were also associated with greater QoL, with an effect size of 2.61 (95% confidence interval, 2.01-14.17) at medium-term follow-up. Compared with placebo and corticosteroid injections, PRP injections provided better pain relief and functional improvement. In subgroup analyses, trials in which PRP was prepared by the double centrifugation technique, the platelet concentration in the PRP was enriched ≥5 times, leucocyte-rich PRP was used, or an activating agent was used before application reported the most effective pain relief at 6-7 months. Conclusions: PRP injections could provide better pain relief and functional outcomes than other treatments for persons presenting with common shoulder diseases. PRP injections have a greater capacity to improve shoulder-related QoL than other interventions.

The effects of a single-dose subacromial injection of a nonsteroidal anti-inflammatory drug in geriatric patients with subacromial impingement syndrome: a randomized double-blind study

  • Kim, Youngbea B;Lee, Woo-Seung;Won, Jun-Sung
    • Clinics in Shoulder and Elbow
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    • v.24 no.1
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    • pp.4-8
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    • 2021
  • Background: As nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids have similar effects, steroids can be avoided to reduce adverse effects. This study aimed to compare the differences in symptom improvement after subacromial injection of steroids or NSAIDs. Methods: Sixty patients with rotator cuff syndrome for at least 3 months were enrolled and divided into steroid and NSAID groups. The steroid group received a mixture of 1 mL of triamcinolone acetonide (40 mg/mL) and 1 mL of lidocaine hydrochloride 2%, while the NSAID group received a mixture of 1 mL of Ketorolac Tromethamine (30 mg/mL) and 1 mL of lidocaine hydrochloride 2%. The patients were assessed before and at 3, 6, and 12 weeks after the procedure. Shoulder scores from visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES), and University of California Los Angeles (UCLA) were used for evaluation. Results: Both groups showed improvements in the clinical outcomes. Overall VAS, ASES, and UCLA scores improved from 6.9, 32.7, and 16.0 before the procedure to 2.0, 1.2, and 1.1; 81.5, 87.6, and 88.5; and 29.7, 31.8, and 32.0 at weeks 3, 6, and 12 weeks after the procedure, respectively. Twenty-six patients (86.7%) in the steroid group and 28 (93.3%) in the NSAID group reported satisfactory treatment outcomes. There were no significant differences in the outcomes between the two groups (p=0.671). Conclusions: Subacromial injection of NSAIDs for rotator cuff tendinitis with shoulder pain had equivalent outcomes with those of steroid injection at the 12-week follow-up.

A Review of Pharmacopuncture Treatment for Frozen Shoulder: A Literature Review of Clinical Trials

  • Jeong, Seong-Mok;Kim, Sung-Jin;Yoon, Jin-Young;Lee, Chang Hee;Shim, Sung-Eun;Kim, Jeong Hyon;Goo, Bon Hyuk;Park, Yeon-Cheol;Seo, Byung-Kwan;Nam, Sang-soo;Baek, Yong-Hyeon
    • Journal of Acupuncture Research
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    • v.35 no.4
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    • pp.169-175
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    • 2018
  • The objective of this study was to review clinical trials of pharmacopuncture treatment for Frozen Shoulder and to evaluate trends in this field. The literature search was performed using PubMed, the Cochrane Library, China National Knowledge Infrastructure, and 5 Korean electronic databases. A combination of "pharmacopuncture," "acupoint injection," "Frozen Shoulder," "adhesive capsulitis," and "periarthritis of shoulder" search terms were used. A total of 9 studies were included in this review. The studies were classified into herbal extract-based (5 types) and animal-based (2 types) pharmacopuncture treatment of Frozen Shoulder. There were 14 different acupoints and Ashi points used in the 9 studies. The total volume of herbal extract-based pharmacopuncture injected was usually between 2 mL and 4 mL, and for animal-based pharmacopuncture it was 1 ml. In most studies of Frozen Shoulder, pain was reduced and function was significantly improved after pharmacopuncture treatment. These results demonstrate that pharmacopuncture alleviates pain and restores function in patients with Frozen Shoulder. Further studies must be conducted on pharmacopuncture for management of Frozen Shoulder.

Role of suprascapular nerve block in idiopathic frozen shoulder treatment: a clinical trial survey

  • Mardani-Kivi, Mohsen;Nabi, Bahram Naderi;Mousavi, Mir-Hashem;Shirangi, Ardeshir;Leili, Ehsan Kazemnejad;Ghadim-Limudahi, Zahra Haghparast
    • Clinics in Shoulder and Elbow
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    • v.25 no.2
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    • pp.129-139
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    • 2022
  • Background: Several therapeutic methods have been proposed for frozen shoulder syndrome. These include suprascapular nerve block, a simple and cost-effective technique that eliminates the need for nonsteroidal anti-inflammatory drug therapy. Methods: This was a clinical trial that included patients with unilateral shoulder joint stiffness. Patients were divided into three groups: those treated with isolated physiotherapy for 12 weeks (PT group), those treated with a single dose intra-articular injection of corticosteroid together with physiotherapy (IACI group), and those treated with a suprascapular nerve block performed with a single indirect injection of 8-mL lidocaine HCL 1% and 2 mL (80 mg) methylprednisolone acetate together with physiotherapy (SSNB group). The variables assessed were age, sex, side of involvement, dominant limb, presence of diabetes, physical examination findings including erythema, swelling, and muscle wasting; palpation and movement findings; shoulder pain and disability index (SPADI) score; and the visual analog scale (VAS) score pre-intervention and at 2-, 4-, 6-, and 12-week post-intervention. Results: Ninety-seven patients were included in this survey (34 cases in the PT group, 32 cases in the IACI group, and 31 cases in the SSNB group). Mean age was 48.55±11.06 years. Fifty-seven cases were female (58.8%) and 40 were male (41.2%). Sixty-eight patients had a history of diabetes (70.1%). VAS and SPADI scores and range of mototion degrees dramatically improved in all cases (p<0.001). Results were best in the SSNB group (p<0.001), and the IACI group showed better results than the PT group (p<0.001). Conclusions: Suprascapular nerve block is an effective therapy with long-term pain relief and increased mobility of the shoulder joint in patients with adhesive capsulitis.