Comparison of Sono-guided Capsular Distension with Fluoroscopically Capsular Distension in Adhesive Capsulitis of Shoulder

OBJECTIVE: To investigate the short-term effects and advantages of sono-guided capsular distension, compared with fluoroscopically guided capsular distension in adhesive capsulitis of shoulder. METHOD: In this prospective, randomized, and controlled trial, 23 patients (group A) were given an intra-articular injection of a mixture of 0.5% lidocaine (9 ml), contrast dye (10 ml), and triamcinolone (20 mg); they received the injection once every 2 weeks, for a total of 6 weeks, under sono-guidance. Twenty-five patients (group B) were treated similarly, under fluoroscopic guidance. Instructions for the self-exercise program were given to all subjects, without physiotherapy and medication. Effects were then assessed using a visual numeric scale (VNS), and the shoulder pain and disability index (SPADI), as well as a range of shoulder motion examinations which took place at the beginning of the study and 2 and 6 weeks after the last injection. Incremental cost-effective ratio (ICER), effectiveness, preference, and procedure duration were evaluated 6 weeks post-injection. RESULTS: The VNS, SPADI, and shoulder motion range improved 2 weeks after the last injection and continued to improve until 6 weeks, in both groups. However, no statistical differences in changes of VNS, SPADI, ROM, and effectiveness were found between these groups. Patients preferred sono-guided capsular distension to fluoroscopically guided capsular distension due to differences in radiation hazards and positional convenience. Procedure time was shorter for sono-guided capsular distension than for fluoroscopically guided capsular distension. CONCLUSION: Sono-guided capsular distension has comparable effects with fluoroscopically guided capsular distension for treatment of adhesive capsulitis of the shoulder. Sono-guided capsular distension can be substituted for fluoroscopic capsular distension and can be advantageous from the viewpoint of radiation hazard mitigation, time, cost-effectiveness and convenience.

Changes of Intraarticular Temperature in the Knee Joint according to the Application Method of Cold Jet-stream

OBJECTIVE: To investigate the changes of intraarticular temperature in the knee according to the application methods of cold jet-stream and to find the more effective method which reduces the intraarticular temperature. METHOD: Fifteen healthy subjects were examined. We recorded both skin and intraarticular temperature of the knee for 120 minutes. We compared two different cooling methods using -30 degrees C cold jet-stream by CRAis(R) (Century, Korea). The first was the intermittent cold jet-stream application method (ICA) which applied cold jet-stream to the knee joint every other minute for 5 minutes and the second was the continuous cold jet-stream application method with infrared (CCAI) for 5 minutes. RESULTS: In ICA, the intraarticular temperature maximally dropped as 1.7+/-0.6 degrees C (p<0.01) and it took 28.7+/-18.9 minutes. Intraarticular temperature dropped 0.6+/-0.5 degrees C after 2 hour (p<0.05). In CCAI, the intraarticular temperature maximally dropped as 2.8+/-0.7 degrees C (p<0.01) and it took 38.0+/-24.6 minutes, intraarticular temperature after 2 hour dropped as 1.36+/-0.75 degrees C (p<0.05). According to the two methods, CCAI showed more reduction in the lowest and after 2 hour intraarticular temperature compared with ICA in the knee joint (p<0.05). CONCLUSION: CCAI is better for reducing the intraarticular temperature than ICA.

The Effect of Isometric and Isotonic Mixed Exercise in Patients with Degenerative Arthritis of Knee

OBJECTIVE: The purpose of this study is to identify how the isotonic and isometric mixed excercise training for 12 weeks take influence on the muscular strength, muscle size and foot pressure (by EMED ) in patients with degenerative knee joint disease. METHOD: Seven patients with degenerative knee joint disease were chosen for the experimental objects and were trained isotonic exercise program for twelve weeks. Before and after exercise, Cybex, Computed Tomography and EMED were examined. RESULTS: After exercise program, peak torque, peak torque %Bwt and average power were significantly increased at 60o/sec and 180o/sec in both knee flexors and extensors. But peak torque ratio flexor/extensor were not significantly increased. Cross-sectional area of quadriceps and hamstrings were significantly increased. But there were no significant difference in the peak pressure at the heel and time (from initiation of initial contact to peak pressure at the heel). CONCLUSION: We knew that isotonic and isometric mixed exercise training to the patients with degenerative knee joint disease for 12 weeks improved the muscular strength and muscle size, but this is not influenced on heel pressure. So, there may be needed to study with kinetic and kinematic analysis to more experimental patients.