The effect of injection volume on long-term outcomes of US-guided subacromial bursa injections.
Eur J Radiol
; 129: 109113, 2020 Aug.
Article
en En
| MEDLINE
| ID: mdl-32540584
ABSTRACT
PURPOSE:
Limited data exist on the efficacy of high- compared to low-volume US-guided corticosteroid injections (CI) in the subacromial-subdeltoid (SA-SD) bursa. Our purpose was to compare the short- and long-term efficacy of low- and high-volume injections, by using a capacity reference of SA-SD bursa volume, as assessed on cadaveric specimens.METHOD:
Within two years, 136 patients (63 males, 73 females; mean age 46.11⯱â¯10.28 years) who underwent SA-SD bursa US-guided CI for subacromial impingement, rotator cuff tendinopathy or shoulder overuse were prospectively included. Patients were randomly assigned to low-volume (1â¯mL triamcinolone acetonide/40â¯mg) or high-volume (1â¯mL triamcinolone acetonide/40â¯mg, 9â¯mL anaesthetic agents) groups (67 and 69 patients, respectively). Visual Analogue Scores (VAS) were recorded at baseline, 30â¯min, 3 weeks, 3 months, 6 months and 1â¯year post-treatment. Predictors of complete recovery (VASâ¯≤â¯2) at 1â¯year were analysed with multivariate Cox regression analysis. SA-SD bursa cadaveric dissection in 10 specimens was performed for volume assessment.RESULTS:
Injection volume was the only predictor of complete pain resolution at 1â¯year. High-volume CI yielded higher chances of early pain recovery (2.837 HR, 95% CI 1.737-4.633, Pâ¯<â¯.001). Mean VAS scores at baseline and subsequent time-points were 6, 2.6, 2.2, 2, 1.6 and 1 for the high-volume and 7.8, 7.3, 4.7, 3.2, 2.5 and 1.8 for the low-volume group, respectively (Pâ¯<â¯.001, at all time-points). Cadaveric measurements showed a minimum SA-SD bursa volume of approximately 6.9â¯mL.CONCLUSIONS:
High-compared to low-volume US-guided CI are superior for achieving early pain recovery.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Triamcinolona Acetonida
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Corticoesteroides
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Ultrasonografía Intervencional
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Síndrome de Abducción Dolorosa del Hombro
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Dolor de Hombro
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur J Radiol
Año:
2020
Tipo del documento:
Article
País de afiliación:
Grecia