Accuracy of Two Ultrasound-Guided Coracohumeral Ligament Injection Approaches: A Cadaveric Study.
Journal
PM & R : the journal of injury, function, and rehabilitation
ISSN: 1934-1563
Titre abrégé: PM R
Pays: United States
ID NLM: 101491319
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
15
06
2018
accepted:
05
12
2018
pubmed:
29
1
2019
medline:
25
7
2020
entrez:
29
1
2019
Statut:
ppublish
Résumé
Glenohumeral idiopathic adhesive capsulitis is a common shoulder condition that hinders functionality. Addressing the pathology has been extensively researched. Ultrasound (US)-guided injections have shown their efficacy. However, no study has been conducted to compare anatomical accuracy between different approaches in targeting the coracohumeral ligament (CHL). To investigate whether US-guided injection of the CHL can be performed accurately using either the rotator interval (RI) or the coracoidal (CO) approach. An experimental cadaveric case series. Anatomy laboratory. Both shoulders of 13 Thiel-embalmed cadavers. Three physiatrists each injected a 0.1 mL bolus of colored dye in both shoulders of each cadaver using either the RI or the CO approach under US guidance. Each cadaver received a total of six injections (three injections per shoulder). The accuracy of the injection was determined following shoulder dissection by an anatomist. The accuracy of the US-guided injection of the CHL. The RI approach yielded 36 accurate injections, giving it an accuracy of 100%. With the CO approach two injections were deemed inaccurate yielding an accuracy of 94%. There was no significant difference in accuracy between all operators. US-guided injection of the CHL can be performed accurately with both the RI and CO approaches. The RI approach was likely to be more accurate.
Sections du résumé
BACKGROUND
Glenohumeral idiopathic adhesive capsulitis is a common shoulder condition that hinders functionality. Addressing the pathology has been extensively researched. Ultrasound (US)-guided injections have shown their efficacy. However, no study has been conducted to compare anatomical accuracy between different approaches in targeting the coracohumeral ligament (CHL).
OBJECTIVE
To investigate whether US-guided injection of the CHL can be performed accurately using either the rotator interval (RI) or the coracoidal (CO) approach.
METHODS
An experimental cadaveric case series.
SETTING
Anatomy laboratory.
SPECIMENS
Both shoulders of 13 Thiel-embalmed cadavers.
INTERVENTIONS
Three physiatrists each injected a 0.1 mL bolus of colored dye in both shoulders of each cadaver using either the RI or the CO approach under US guidance. Each cadaver received a total of six injections (three injections per shoulder). The accuracy of the injection was determined following shoulder dissection by an anatomist.
MAIN OUTCOME MEASURE
The accuracy of the US-guided injection of the CHL.
RESULTS
The RI approach yielded 36 accurate injections, giving it an accuracy of 100%. With the CO approach two injections were deemed inaccurate yielding an accuracy of 94%. There was no significant difference in accuracy between all operators.
CONCLUSIONS
US-guided injection of the CHL can be performed accurately with both the RI and CO approaches. The RI approach was likely to be more accurate.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
989-995Informations de copyright
© 2019 American Academy of Physical Medicine and Rehabilitation.
Références
Hand C, Clipsham K, Rees JL, Carr AJ. Long-term outcome of frozen shoulder. J Shoulder Elbow Surg. 2008;17(2):231-236.
Carbone S, Gumina S, Vestri AR, Postacchini R. Coracoid pain test: a new clinical sign of shoulder adhesive capsulitis. Int Orthop. 2010;34(3):385-388.
Bunker TD. Frozen shoulder: unravelling the enigma. Ann R Coll Surg Engl. 1997;79(3):210-213.
Dias R, Cutts S, Massoud S. Frozen shoulder. BMJ. 2005;331(7530):1453-1456.
Neer CS 2nd, Satterlee CC, Dalsey RM, Flatow EL. The anatomy and potential effects of contracture of the coracohumeral ligament. Clin Orthop Relat Res. 1992;280:182-185.
Ozaki J, Nakagawa Y, Sakurai G, Tamai S. Recalcitrant chronic adhesive capsulitis of the shoulder. Role of contracture of the coracohumeral ligament and rotator interval in pathogenesis and treatment. J Bone Joint Surg Am. 1989;71(10):1511-1515.
Lee JC, Sykes C, Saifuddin A, Connell D. Adhesive capsulitis: sonographic changes in the rotator cuff interval with arthroscopic correlation. Skeletal Radiol. 2005;34(9):522-527.
Mengiardi B, Pfirrmann CW, Gerber C, Hodler J, Zanetti M. Frozen shoulder: MR arthrographic findings. Radiology. 2004;233(2):486-492.
Omari A, Bunker TD. Open surgical release for frozen shoulder: surgical findings and results of the release. J Shoulder Elbow Surg. 2001;10(4):353-357.
Tamai K, Akutsu M, Yano Y. Primary frozen shoulder: brief review of pathology and imaging abnormalities. J Orthop Sci. 2014;19(1):1-5.
Arai R, Nimura A, Yamaguchi K, et al. The anatomy of the coracohumeral ligament and its relation to the subscapularis muscle. J Shoulder Elbow Surg. 2014;23(10):1575-1581.
Tamborrini G, Möller I, Bong D, et al. The rotator interval - a link between anatomy and ultrasound. Ultrasound Int Open. 2017;03(03):E107-E116.
Ryan V, Brown H, Minns Lowe CJ, Lewis JS. The pathophysiology associated with primary (idiopathic) frozen shoulder: a systematic review. BMC Musculoskelet Disord. 2016;17(1):340.
Homsi C, Bordalo-Rodrigues M, da Silva JJ, Stump XM. Ultrasound in adhesive capsulitis of the shoulder: is assessment of the coracohumeral ligament a valuable diagnostic tool? Skeletal Radiol. 2006;35(9):673-678.
Oh JH, Oh CH, Choi JA, Kim SH, Kim JH, Yoon JP. Comparison of glenohumeral and subacromial steroid injection in primary frozen shoulder: a prospective, randomized short-term comparison study. J Shoulder Elbow Surg. 2011;20(7):1034-1040.
Yukata K, Goto T, Sakai T, Fujii H, Hamawaki J, Yasui N. Ultrasound-guided coracohumeral ligament release. Orthop Traumatol Surg Res. 2018;104:823-827.
Lee J, Sykes C, Saifuddin A, Connell D. Adhesive capsulitis: sonographic changes in the rotator cuff interval with arthroscopic correlation. Skeletal Radiol. 2005;34(9):522-527.
Cinar M, Akpinar S, Derincek A, Circi E, Uysal M. Comparison of arthroscopic capsular release in diabetic and idiopathic frozen shoulder patients. Arch Orthop Trauma Surg. 2010;130(3):401-406.
Ahn K, Lee YJ, Kim EH, et al. Interventional microadhesiolysis: a new nonsurgical release technique for adhesive capsulitis of the shoulder. BMC Musculoskelet Disord. 2008;9:12.
Ruiz JO. Positional stretching of the coracohumeral ligament on a patient with adhesive capsulitis: a case report. J Man Manip Ther. 2009;17(1):58-63.
Sizer PS Jr, Phelps V, Gilbert K. Diagnosis and management of the painful shoulder. Part 2: examination, interpretation, and management. Pain Pract. 2003;3(2):152-185.
Çınar M, Akpınar S, Derincek A, Circi E, Uysal M. Comparison of arthroscopic capsular release in diabetic and idiopathic frozen shoulder patients. Arch Orthop Trauma Surg. 2010;130(3):401-406.
Arslan S, Celiker R. Comparison of the efficacy of local corticosteroid injection and physical therapy for the treatment of adhesive capsulitis. Rheumatol Int. 2001;21(1):20-23.
Bal A, Eksioglu E, Gulec B, Aydog E, Gurcay E, Cakci A. Effectiveness of corticosteroid injection in adhesive capsulitis. Clin Rehabil. 2008;22(6):503-512.
Lubiecki M, Carr A. Frozen shoulder: past, present, and future. J Orthop Surg (Hong Kong). 2007;15(1):1-3.
Marx RG, Malizia RW, Kenter K, Wickiewicz TL, Hannafin JA. Intra-articular corticosteroid injection for the treatment of idiopathic adhesive capsulitis of the shoulder. HSS J. 2007;3(2):202-207.
Neviaser AS, Hannafin JA. Adhesive capsulitis: a review of current treatment. Am J Sports Med. 2010;38(11):2346-2356.
Song A, Higgins LD, Newman J, Jain NB. Glenohumeral corticosteroid injections in adhesive capsulitis: a systematic search and review. PM R. 2014;6(12):1143-1156.
Shah N, Lewis M. Shoulder adhesive capsulitis: systematic review of randomised trials using multiple corticosteroid injections. Br J Gen Pract. 2007;57(541):662-667.
Sun Y, Liu S, Chen S, Chen J. The effect of corticosteroid injection into rotator interval for early frozen shoulder: a randomized controlled trial. Am J Sports Med. 2018;46(3):663-670.
Standring S, Gray H. Gray's Anatomy: The Anatomical Basis of Clinical Practice. Edinburgh: Churchill Livingstone/Elsevier; 2008.
Ferrari DA. Capsular ligaments of the shoulder. Anatomical and functional study of the anterior superior capsule. Am J Sports Med. 1990;18(1):20-24.
Wu CH, Chen WS, Wang TG. Elasticity of the coracohumeral ligament in patients with adhesive capsulitis of the shoulder. Radiology. 2016;278(2):458-464.
Shin SJ, Lee SY. Efficacies of corticosteroid injection at different sites of the shoulder for the treatment of adhesive capsulitis. J Shoulder Elbow Surg. 2013;22(4):521-527.
Prestgaard T, Wormgoor ME, Haugen S, Harstad H, Mowinckel P, Brox JI. Ultrasound-guided intra-articular and rotator interval corticosteroid injections in adhesive capsulitis of the shoulder: a double-blind, sham-controlled randomized study. Pain. 2015;156(9):1683-1691.
Juel NG, Oland G, Kvalheim S, Love T, Ekeberg OM. Adhesive capsulitis: one sonographic-guided injection of 20 mg triamcinolon into the rotator interval. Rheumatol Int. 2013;33(6):1547-1553.
Shah V, Bendele A, Dines JS, et al. Dose-response effect of an intra-tendon application of recombinant human platelet-derived growth factor-BB (rhPDGF-BB) in a rat Achilles tendinopathy model. J Orthop Res. 2013;31(3):413-420.