EFFICACY COMPARISON OF SUBACROMIAL AND POSTERIOR APPROACH GLENOHUMERAL JOINT INJECTIONS USING TRIAMCINOLONE ACETONIDE IN CASES OF PRIMAR
Keywords:Adhesive capsulitis, Intraarticular injections, Joint range of motion, Shoulder pain, Triamcinolone acetonide
Objective: To compare the efficacy of subacromial and posterior approach glenohumeral joint injections using triamcinolone acetonide in cases of primary adhesive capsulitis.
Study Design: Quasi-experimental study.
Place and Duration of Study: Pain Clinics of Armed Forces Institute of Rehabilitation Medicine Rawalpindi and Combined Military Hospital Jhelum, from May to Nov 2014 and from Jan to Jul 2019 respectively.
Methodology: We included patients with primary adhesive capsulitis in stage 1 and 2. The pain, measured by Numeric Rating Scale and range of motion of the affected joint measured through goniometer before and four weeks after the injection were the study parameters. A 40-mg injection of triamcinolone acetonide was given blindly into the affected shoulder joint through subacromial injection in 45 patients (group A) and posterior glenohumeral injection in 43 patients (group B).
Results: Each group had a significant reduction in mean pain score after four weeks of treatment (p<0.001) and a significant increase in range of motion in flexion, abduction, internal, and external rotation after treatment (p<0.001). The mean reduction in pain score for group B was significantly greater than the mean pain reduction for group A (p<0.001). The mean increase in flexion and internal rotation was significantly greater in group B, compared to group A (p=0.003 and p<0.001, respectively).
Conclusions: The posterior glenohumeral injection of triamcinolone acetonide when compared with subacromial injection, was significantly more effective in reducing pain, and improving range of motion especially in flexion and internal rotation in patients with primary adhesive capsulitis.