Document Detail

Nonoperative management of adhesive capsulitis of the shoulder: oral cortisone application versus intra-articular cortisone injections.
MedLine Citation:
PMID:  19800262     Owner:  NLM     Status:  MEDLINE    
HYPOTHESIS: Oral and intra-articular injections of cortisone will lead to significant improvement and comparable results in the treatment of adhesive capsulitis of the shoulder. MATERIALS AND METHODS: In a prospective randomized evaluation, 40 patients with idiopathic adhesive capsulitis of the shoulder were treated with an oral corticoid treatment regimen or 3 intra-articular injections of corticosteroids. Follow-up was after 4, 8, and 12 weeks, and 6 and 12 months. For the clinical evaluation, the Constant-Murley (CM) score, the Simple Shoulder Test (SST) and visual analog scales (VAS) for pain, function, and satisfaction were used. RESULTS: In the patients treated with oral glucocorticoids, significant improvements were found for the CM score (P < .0001), SST (P=.035), VAS (P < .0001), and range of motion (P < .05) at the 4-week follow-up. The patients treated with an intra-articular glucocorticoid injection series also significantly improved in the CM score (P < .0001), SST (P < .0001), the VAS (P < .0001), and range of motion (P < .05) after 4 weeks. These results were confirmed at all other follow-up visits. Superior results were found for intra-articular injections in range of motion, CM score, SST, and patient satisfaction (P < .05). Differences in the VAS for pain and function were not significant (P > .05). DISCUSSION: The use of cortisone in the treatment of idiopathic shoulder adhesive capsulitis leads to fast pain relief and improves range of motion. Intra-articular injections of glucocorticoids showed superior results in objective shoulder scores, range of motion, and patient satisfaction compared with a short course of oral corticosteroids.
Olaf Lorbach; Konstantinos Anagnostakos; Cornelia Scherf; Romain Seil; Dieter Kohn; Dietrich Pape
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-10-01
Journal Detail:
Title:  Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]     Volume:  19     ISSN:  1532-6500     ISO Abbreviation:  J Shoulder Elbow Surg     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-26     Completed Date:  2010-06-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206499     Medline TA:  J Shoulder Elbow Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  172-9     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.
Department of Orthopedic and Trauma Surgery, Klinikum Osnabr?ck, Handsurgery, Osnabr?ck, Germany.
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MeSH Terms
Administration, Oral
Anti-Inflammatory Agents / therapeutic use
Bursitis / complications,  drug therapy*,  pathology,  rehabilitation
Dose-Response Relationship, Drug
Drug Administration Schedule
Injections, Intra-Articular
Middle Aged
Pain Measurement
Patient Satisfaction
Prednisolone / therapeutic use*
Prospective Studies
Range of Motion, Articular / drug effects*,  physiology
Recovery of Function
Severity of Illness Index
Shoulder Joint*
Shoulder Pain / diagnosis,  drug therapy,  etiology,  rehabilitation
Tissue Adhesions / pathology
Reg. No./Substance:
0/Anti-Inflammatory Agents; 50-24-8/Prednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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