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Capsule preservation improves short‐term outcome of hydraulic distension in painful stiff shoulder
Author(s) -
Kim Keewon,
Lee Kyu Jin,
Kim Hee Chan,
Lee KunJai,
Kim DonKyu,
Chung Sun G.
Publication year - 2011
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.21446
Subject(s) - distension , capsule , term (time) , medicine , surgery , geology , physics , paleontology , quantum mechanics
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. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 29:1688–1694, 2011