Predictive Factors for Failure of Intraarticular Injection in Management of Adhesive Capsulitis of the Shoulder
Intraarticular (IA) corticosteroid injections have been demonstrated to be an effective management for adhesive capsulitis in both the short- and mid-term. Yet, certain patients fail to improve both subjectively and clinically. This study aims to identify predictive factors for treatment failure of...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/20/6212 |
| _version_ | 1797431482612973568 |
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| author | Stefan J. Hanish Mathew L. Resnick Hyunmin M. Kim Matthew J. Smith |
| author_facet | Stefan J. Hanish Mathew L. Resnick Hyunmin M. Kim Matthew J. Smith |
| author_sort | Stefan J. Hanish |
| collection | DOAJ |
| description | Intraarticular (IA) corticosteroid injections have been demonstrated to be an effective management for adhesive capsulitis in both the short- and mid-term. Yet, certain patients fail to improve both subjectively and clinically. This study aims to identify predictive factors for treatment failure of IA injections in management of adhesive capsulitis. A retrospective review found 533 patients undergoing IA corticosteroid or IA NSAID injection for adhesive capsulitis between June 2015 and May 2020 at a single healthcare institution. Patient demographics characteristics, comorbidities, pain scores, and range of motion were compared. Treatment failure was defined as need for subsequent IA injection within 6 months or progression to surgical management within 12 months. 152 patients (28.52%) experienced treatment failure of IA corticosteroid injection. Pre-injection pain scores were greater for those who experienced treatment failure (5.40 vs. 4.21, <i>p</i> < 0.05). Post-injection pain scores were greater for those who experienced treatment failure (3.77 vs. 2.17, <i>p</i> < 0.01). Reduced post-injection external rotation in abduction also predicted treatment failure (56.88° vs. 70.22°, <i>p</i> < 0.01). IA corticosteroid injections are associated with increased rates of failure and progression to surgical management when patients present with increased pain levels as well as with less improvement in pain levels and ROM following injection. |
| first_indexed | 2024-03-09T09:45:43Z |
| format | Article |
| id | doaj.art-5728ebea1d0e4215b5c14cbc8c21838d |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T09:45:43Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-5728ebea1d0e4215b5c14cbc8c21838d2023-12-02T00:34:09ZengMDPI AGJournal of Clinical Medicine2077-03832022-10-011120621210.3390/jcm11206212Predictive Factors for Failure of Intraarticular Injection in Management of Adhesive Capsulitis of the ShoulderStefan J. Hanish0Mathew L. Resnick1Hyunmin M. Kim2Matthew J. Smith3Department of Orthopaedic Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USADepartment of Orthopaedic Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USADepartment of Orthopaedic Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USADepartment of Orthopaedic Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USAIntraarticular (IA) corticosteroid injections have been demonstrated to be an effective management for adhesive capsulitis in both the short- and mid-term. Yet, certain patients fail to improve both subjectively and clinically. This study aims to identify predictive factors for treatment failure of IA injections in management of adhesive capsulitis. A retrospective review found 533 patients undergoing IA corticosteroid or IA NSAID injection for adhesive capsulitis between June 2015 and May 2020 at a single healthcare institution. Patient demographics characteristics, comorbidities, pain scores, and range of motion were compared. Treatment failure was defined as need for subsequent IA injection within 6 months or progression to surgical management within 12 months. 152 patients (28.52%) experienced treatment failure of IA corticosteroid injection. Pre-injection pain scores were greater for those who experienced treatment failure (5.40 vs. 4.21, <i>p</i> < 0.05). Post-injection pain scores were greater for those who experienced treatment failure (3.77 vs. 2.17, <i>p</i> < 0.01). Reduced post-injection external rotation in abduction also predicted treatment failure (56.88° vs. 70.22°, <i>p</i> < 0.01). IA corticosteroid injections are associated with increased rates of failure and progression to surgical management when patients present with increased pain levels as well as with less improvement in pain levels and ROM following injection.https://www.mdpi.com/2077-0383/11/20/6212adhesive capsulitisfrozen shouldercorticosteroidinjectionfailurediabetes mellitus |
| spellingShingle | Stefan J. Hanish Mathew L. Resnick Hyunmin M. Kim Matthew J. Smith Predictive Factors for Failure of Intraarticular Injection in Management of Adhesive Capsulitis of the Shoulder Journal of Clinical Medicine adhesive capsulitis frozen shoulder corticosteroid injection failure diabetes mellitus |
| title | Predictive Factors for Failure of Intraarticular Injection in Management of Adhesive Capsulitis of the Shoulder |
| title_full | Predictive Factors for Failure of Intraarticular Injection in Management of Adhesive Capsulitis of the Shoulder |
| title_fullStr | Predictive Factors for Failure of Intraarticular Injection in Management of Adhesive Capsulitis of the Shoulder |
| title_full_unstemmed | Predictive Factors for Failure of Intraarticular Injection in Management of Adhesive Capsulitis of the Shoulder |
| title_short | Predictive Factors for Failure of Intraarticular Injection in Management of Adhesive Capsulitis of the Shoulder |
| title_sort | predictive factors for failure of intraarticular injection in management of adhesive capsulitis of the shoulder |
| topic | adhesive capsulitis frozen shoulder corticosteroid injection failure diabetes mellitus |
| url | https://www.mdpi.com/2077-0383/11/20/6212 |
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