Comparison of accuracy of anterior and superomedial approaches to shoulder injection: an experimental study

Introduction: We aimed to compare the accuracy between the standard anterior technique of shoulder injection and the new superomedial technique modified from Neviaser arthroscopic portal placement. Intra-articular placement, especially at the long head of biceps (LHB) tendon, and needle depth were e...

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Main Authors: Chernchujit Bancha, Zonthichai Nutthapon
Format: Article
Language:English
Published: EDP Sciences 2016-01-01
Series:SICOT-J
Subjects:
Online Access:http://dx.doi.org/10.1051/sicotj/2015044
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author Chernchujit Bancha
Zonthichai Nutthapon
author_facet Chernchujit Bancha
Zonthichai Nutthapon
author_sort Chernchujit Bancha
collection DOAJ
description Introduction: We aimed to compare the accuracy between the standard anterior technique of shoulder injection and the new superomedial technique modified from Neviaser arthroscopic portal placement. Intra-articular placement, especially at the long head of biceps (LHB) tendon, and needle depth were evaluated. Methods: Fifty-eight patients (ages 57 ± 10 years) requiring shoulder arthroscopy in the beach-chair position were recruited. Needle punctures for both techniques were performed by an experienced sports medicine orthopedist. Patients were anesthetized, and the shoulder placed in the neutral position. A single needle was passed through the skin, with only one redirection allowed per trial. The superomedial technique was performed, then the anterior technique. Posterior-portal arthroscopy determined whether needle placement was inside the joint. The percentage of intra-articular needle placements for each technique defined accuracy. When inside the joint, the needle’s precise location was determined and its depth measured. A marginal χ2 test compared results between techniques. Results: The superomedial technique was significantly more accurate than the anterior technique (84% vs. 55%, p < 0.05). For superomedial versus anterior attempts, the LHB tendon was penetrated in 4% vs. 28% of patients, respectively, and the superior labrum in 35% vs. 0% of patients, respectively; the needle depth was 42 ± 7 vs. 32 ± 7 mm, respectively (all p < 0.05). Conclusions: The superomedial technique was more accurate, penetrating the LHB tendon less frequently than the standard anterior technique. A small-diameter needle was needed to minimize superior labral injury. The superomedial technique required a longer needle to access the shoulder joint.
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spelling doaj.art-b9163b7737e948bcb4fa3df92ad802912022-12-21T22:50:11ZengEDP SciencesSICOT-J2426-88872016-01-0121310.1051/sicotj/2015044sicotj150168Comparison of accuracy of anterior and superomedial approaches to shoulder injection: an experimental studyChernchujit BanchaZonthichai NutthaponIntroduction: We aimed to compare the accuracy between the standard anterior technique of shoulder injection and the new superomedial technique modified from Neviaser arthroscopic portal placement. Intra-articular placement, especially at the long head of biceps (LHB) tendon, and needle depth were evaluated. Methods: Fifty-eight patients (ages 57 ± 10 years) requiring shoulder arthroscopy in the beach-chair position were recruited. Needle punctures for both techniques were performed by an experienced sports medicine orthopedist. Patients were anesthetized, and the shoulder placed in the neutral position. A single needle was passed through the skin, with only one redirection allowed per trial. The superomedial technique was performed, then the anterior technique. Posterior-portal arthroscopy determined whether needle placement was inside the joint. The percentage of intra-articular needle placements for each technique defined accuracy. When inside the joint, the needle’s precise location was determined and its depth measured. A marginal χ2 test compared results between techniques. Results: The superomedial technique was significantly more accurate than the anterior technique (84% vs. 55%, p < 0.05). For superomedial versus anterior attempts, the LHB tendon was penetrated in 4% vs. 28% of patients, respectively, and the superior labrum in 35% vs. 0% of patients, respectively; the needle depth was 42 ± 7 vs. 32 ± 7 mm, respectively (all p < 0.05). Conclusions: The superomedial technique was more accurate, penetrating the LHB tendon less frequently than the standard anterior technique. A small-diameter needle was needed to minimize superior labral injury. The superomedial technique required a longer needle to access the shoulder joint.http://dx.doi.org/10.1051/sicotj/2015044AccuracyShoulder injectionSuperomedial approachNeviaser
spellingShingle Chernchujit Bancha
Zonthichai Nutthapon
Comparison of accuracy of anterior and superomedial approaches to shoulder injection: an experimental study
SICOT-J
Accuracy
Shoulder injection
Superomedial approach
Neviaser
title Comparison of accuracy of anterior and superomedial approaches to shoulder injection: an experimental study
title_full Comparison of accuracy of anterior and superomedial approaches to shoulder injection: an experimental study
title_fullStr Comparison of accuracy of anterior and superomedial approaches to shoulder injection: an experimental study
title_full_unstemmed Comparison of accuracy of anterior and superomedial approaches to shoulder injection: an experimental study
title_short Comparison of accuracy of anterior and superomedial approaches to shoulder injection: an experimental study
title_sort comparison of accuracy of anterior and superomedial approaches to shoulder injection an experimental study
topic Accuracy
Shoulder injection
Superomedial approach
Neviaser
url http://dx.doi.org/10.1051/sicotj/2015044
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AT zonthichainutthapon comparisonofaccuracyofanteriorandsuperomedialapproachestoshoulderinjectionanexperimentalstudy