title: Capsule preservation improves short-term outcome of hydraulic distension in painful stiff shoulder.
abstract: The effect of intraarticular hydraulic distension (IHD) for a painful stiff shoulder (or adhesive capsulitis) has been affirmed, but whether rupturing the joint capsule during this process is beneficial remains controversial. By monitoring real-time pressure-volume (PV) profiles during IHD, we could infuse the largest possible volume without rupturing the capsule. Using the novel technique, we compared the short-term effects of IHD when the capsule was preserved versus when it was ruptured. Fifty-four patients with a painful stiff shoulder underwent IHDs intended to preserve or rupture the capsule and then classified into capsule-ruptured (n = 26) and capsule-preserved (n = 20) groups, based on the obtained PV profiles. Their profiles were triphasic or biphasic; eight with flat profiles were excluded from the comparison. Clinical outcomes were evaluated at 3-day and 1-month follow-ups, in terms of pain and range of motion (ROM). Although both groups showed significant increase in ROM and decrease in pain after IHD, the improvements were greater in the capsule-preserved group than in the ruptured group at both follow-up times, and in triphasic and biphasic cases. In conclusion, the therapeutic effects of IHD in short-term follow-ups were enhanced by preserving the capsule.
authors.affiliation: Department of Rehabilitation Medicine, College of Medicine, Seoul National University, 101 Daehang-ro, Jongno-gu, Seoul 110-744, South Korea.
authors.forename: Keewon
authors.initials: K
authors.lastname: Kim
authors.forename: Kyu Jin
authors.initials: KJ
authors.lastname: Lee
authors.forename: Hee Chan
authors.initials: HC
authors.lastname: Kim
authors.forename: Kun-Jai
authors.initials: KJ
authors.lastname: Lee
authors.forename: Don-Kyu
authors.initials: DK
authors.lastname: Kim
authors.forename: Sun G
authors.initials: SG
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D002062:Bursitis / Q000503:physiopathology* / Q000534:rehabilitation; D005081:Exercise Therapy / Q000379:methods; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods; D017746:Joint Capsule / Q000502:physiology*; D008875:Middle Aged; D011312:Pressure; D020127:Recovery of Function / Q000502:physiology; D012421:Rupture; D012785:Shoulder Joint / Q000502:physiology; D020069:Shoulder Pain / Q000503:physiopathology* / Q000534:rehabilitation; D012965:Sodium Chloride / Q000008:administration & dosage; D007507:Therapeutic Irrigation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D012965:Sodium Chloride