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Rehabilitation Practice and Science

Translated Title

關節內注射玻尿酸鈉製劑對沾黏性肩關節囊炎患者療效之評估

Abstract

The etiology and natural history of adhesive capsulitis remain obscure, which limited subsequent management. Traditional treatments include conservative medical therapy and physical therapy, but severe shoulder pain may constitute an obstacle to joint mobilization. Local steroid injection into or around the shoulder joint has been shown to alleviate pain in early stages of the disease. Late disease appears less responsive and there are many known risks of complications. Many different protocols to treat the disease have been reported, but the results are generally unsatisfatcory and difficult to compare.Our goal was to determine the efficacy of a combined treatment-intraarticular injection of sodium hyaluronate plus rehabilltation treatment-in the management of adhesive capsulitis of the shoulder. To this end, sixty patients with established adhesive capsulitis were enrolled. The patients were randomly allocated to receive intraarticular injection of sodium hyaluronate and rehabilitation or rehabilitation alone. Intraarticular injections with 2.5 cc sodium hyaluronate (25 mg) were performed once weekly for 5 weeks by injection into the glenoid cavity using an anterior approach. Physiotherapy was performed for 12 weeks in both groups. Of 60 patients seen between January 2003 and October 2004, follow-up was completed for 47 (78%). The results show an improvement in both groups on most measures of treatment effectiveness, including joint mobility, pain and disability after 3 months, even more so in the patients treated with combined sodium hyaluronate and physiotherapy. No adverse effects were reported. These results strongly suggest that combined sodium hyaluronate and rehabilitation treatment are effective for the treatment of patients with adhesive capsulitis.

Language

Traditional Chinese

First Page

221

Last Page

227

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