Single Corticosteroid Injection Research Articles

Comparing Intraoperative and In-Office Steroid Injections for Management of Subglottic Stenosis.

Intralesional corticosteroid injection for management of subglottic stenosis (SGS) is thought to improve patients' surgery free interval (SFI). The objective of this study was to determine the difference in SFI between idiopathic SGS (iSGS) patients treated with endoscopic dilation alone, dilation with a single intraoperative intralesional corticosteroid injection, or dilation with intraoperative steroid injection followed by serial in-office serial intralesional steroid injection (SILSI) procedures. Retrospective review of patients with iSGS from 1/1/2012 to 12/1/2023. The SFI was calculated as the time between surgical interventions and independent samples median test was used to compare the difference in SFIs between treatment groups. This study identified 305 procedures, involving 104 patients. Fifty-five procedures involved endoscopic dilation alone (median SFI = 658, IQR: 595 days), 102 involved one injection of steroids intraoperatively (median SFI = 395, IQR: 296 days), 27 involved endoscopic dilation (ED) followed by a single postoperative ILSI (median SFI = 533, IQR: 351), and 15 involved postoperative SILSI (median SFI = 585, IQR: 338 days). Comparing SFI between groups found mean SFI was significantly longer among patients managed with only ED compared with a single intraoperative steroid injection (p = 0.001). Patients who were initially managed with ED and an intraoperative steroid injection has a statistically significant decrease in SFI (p = 0.032) when transitioned to management with ED and intraoperative steroid injection followed by a single ILSI postoperatively. Patients who received a single intraoperative steroid injection experienced shorter SFI when compared with those managed with dilation alone. SILSI did not result in a significant increase of SFI within this population. 3 Laryngoscope, 2024.

Outcomes of Single Corticosteroid Injection in De Quervain's Tenosynovitis

Outcomes of Single Corticosteroid Injection in De Quervain's Tenosynovitis

Evaluation of Functional Outcome of Single Dose Intralesional Autologous Blood Vs Corticosteroid Injection in Chronic Plantar Fascitis

Introduction: Plantar fascitis is one of the main underlying causes of acute and chronic heel pain. Diagnosis is mainly based on clinical symptoms and most of the time diagnostic imaging is not required routinely. Corticosteroid injection and autologous blood injection has been a possible means of treatment. Injection of autologous blood can help stimulate a healing response in chronic tendon disorders. Aims: To compare the functional outcome of single dose intra-lesional injection of autologous blood and corticosteroid in chronic plantar fascitis. Methods: This study was done in Nepalgunj medical college and teaching hospital during the period of March 2023 to August 2023 in the department of orthopedics. Sixty patients were enrolled in the study with 30 patients in each group. The patients were selected according to our inclusion and exclusion criteria and diagnosis made on clinical examination alone. The pain status was noted on the visual analog scale and the activity level noted based on the Nirschl stage. The final outcome was based on our scoring system based on the pain status and the activity level at two, four- and twelve-weeks’ duration and graded into four categories as excellent, good, and acceptable and poor. Results: We found that in chronic plantar fascitis, local intralesional steroid injection gives better pain relief and faster return to activities of daily living compared to autologous blood injections. In our study we found that 17.85% had excellent outcome, 35.72% had good outcome and 12% had acceptable outcome in steroid group, whereas in autologous blood group 7.40% had excellent, 22.22% had good and 70.37% had acceptable outcome respectively. Conclusion: Intralesional steroid injection in chronic plantar fascitis have shown to achieve better functional outcome than autologous blood injection.

The Disease-Modifying Effects of a Single Intra-Articular Corticosteroid Injection during the Freezing Phase of Frozen Shoulder in an Animal Model.

Although frequently prescribed for frozen shoulder, it is not known if corticosteroid injections improve the course of frozen shoulder. This study aimed to assess the disease-modifying effects of an intra-articular corticosteroid administration at the freezing phase of frozen shoulder. Twenty-four Sprague-Dawley rats were divided into four groups. Their unilateral shoulders were immobilized for the first 3 days in all groups, followed by an intra-articular corticosteroid injection in Group A, an injection and the cessation of immobilization in Group B, no further intervention in Group C, and the cessation of immobilization in Group D. All rats were sacrificed in Week 3 of study, at which point the passive shoulder abduction angles were measured and the axillary recess tissues were retrieved for histological and Western blot analyses. The passive shoulder abduction angles at the time of sacrifice were 138° ± 8° (Group A), 146° ± 5° (Group B), 95° ± 11° (Group C), 132° ± 8° (Group D), and 158° ± 2° (Control). The histological assessments and Western blots showed greater fibrosis and inflammation in the groups that did not receive the corticosteroid injection (Groups C and D) compared to the corticosteroid-injected groups (Groups A and B). These findings demonstrate the anti-inflammatory and disease-modifying effects of corticosteroid injections during the freezing phase of frozen shoulder in an animal model.

Comparative Study between Platelet-Rich Plasma, Corticosteroids and Perineural Dextrose local Injections for Treatment of Carpal Tunnel Syndrome

Abstract Background Carpal tunnel syndrome (CTS), one of the most common entrapment neuropathies, is considered as a socio- economic issue that reduces work productivity and increases disability. Aim of the Work to compare the effect of Platelet- Rich Plasma (PRP), corticosteroids (CS) and perineural Dextrose 5 % in water (D5W) local injections for the treatment of idiopathic mild and moderate CTS. Patients and Methods A prospective study was performed on 60 median nerves of 60 patients. They were diagnosed as idiopathic CTS and classified randomly into 3 groups (each contains 20 patients) according to the treatment program received: group I (ultrasound guided CS injection), group II (ultrasound guided perineural Dextrose 5% injection) and group III (ultrasound guided PRP injection). Results Ultrasound guided local injection using single doses of CS, D5W, and PRP were very efficient as regards symptomatic and functional improvement, reducing distal motor latency (DML) and Peak sensory latency ( PSL) of median nerve, as well as decreased Cross Section Area (CSA) of Median nerve (MN) and improving median nerve mobility for idiopathic mild to moderate CTS. For symptom and functional improvement, single injection of CS was more effective than that of PRP and D5W within 3 months post-injection. Moreover, PRP was slightly better than D5W. For reducing DML and PSL, CS was the most effective followed by PRP and then D5W at 3 months post injection. For reducing CSA, CS was the most effective followed by PRP and then D5W at 3 months post injection. For improving mobility of median nerve, D5W was the most effective at 3 months post injection followed by CS and PRP. Conclusion Injection of CS, D5W and PRP had resulted in significant Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) score reduction at 3 months post-injection in comparison to the BCTQ score at the baseline evaluation. All of the three studied groups (Corticosteroids, dextrose 5 % and PRP) have shown a great result regarding improving in clinical examination, clinical assessment scales, nerve conduction studies and improving in Neuromuscular Ultrasound results with favorable results of Corticosteroids group over Perineural dextrose 5 % group and PRP group.

INVESTIGATING THE EFFICACY OF SURGICAL AND NON-SURGICAL TREATMENT OPTIONS FOR MORTON'S NEUROMA BASED ON THEIR SIZE

Data was collected for patients referred to the orthopaedic department at Forth Valley Royal Hospital with metatarsalgia who subsequently received an ultrasound. Patients found to have a Morton's neuroma were divided into groups based on its size.A total of 90 patients received an ultrasound scan and neuroma was confirmed in 58 with an alternative diagnosis found in 32 patients and a total of 42 were included in the final analysis.All 14 patients with neuroma < 6mm reported resolution of symptoms. 4 (28.5%) underwent surgical excision as first line, 1 (7%) received a single corticosteroid injection and 9 (64%) were treated with metatarsal bars.There were 27 patients with neuroma > 6mm; 8 (29.6%) underwent surgical excision as first line treatment, 5 (18.5%) received metatarsal bars and 14 (51.9%) received injections. 7 (25.9%) patients reported resolution of symptoms after 1 injection, 1 (3.7%) patient required 2 injections and 1 (3.7%) patient required 3 injections to achieve resolution. 5 (18.5%) patients required surgical excision following ongoing symptoms despite non-surgical treatment. 9 (33.3%) reported resolution of symptoms following injection. 5 (18.5%) reported resolution of symptoms following use of metatarsal bars.A total of 71% of patients with a neuroma measuring < 6mm reported full resolution of symptoms with non-surgical treatment. For patients with neuroma >6mm, 64.3% had resolution of symptoms with injections alone and 18.5% required surgical excision despite injection.In conclusion, there is a benefit to offering non-surgical treatment as first line in patients with a neuroma regardless of size.

Investigation Into the Effects of Intra-Articular Steroid on Post-Traumatic Osteoarthritis in Distal Radius Fractures: A Randomized Controlled Pilot Study

The aim of this prospective, randomized, controlled, double-blinded pilot study was to determine the rates of post-traumatic osteoarthritis and assess joint space width in the presence or absence of a single intra-articular injection of corticosteroid after an acute, intra-articular distal radius fracture (DRF). Forty patients received a single, intra-articular, radiocarpal joint injection of 4 mg of dexamethasone (DEX) (n= 19) or normal saline placebo (n= 21) within 2 weeks of a surgically or nonsurgically treated intra-articular DRF. The primary outcome measure was minimum radiocarpal joint space width (mJSW) on noncontrast computed tomography scans at 2 years postinjection. Secondary outcomes were obtained at 3 months, 6 months, 1 year, and 2 years postinjection and included Disabilities of the Arm, Shoulder, and Hand; Michigan Hand Questionnaire; Patient-Rated Wrist Evaluation; wrist range of motion; and grip strength. At 2-year follow-up, there was no difference in mean mJSW between the DEX group (2.2 mm; standard deviation, 0.6; range, 1.4-3.2) and the placebo group (2.3 mm; standard deviation, 0.7; range, 0.9-3.9). Further, there were no differences in any secondary outcome measures at any postinjection follow-up interval. Radiocarpal joint injection of corticosteroid within 2 weeks of an intra-articular DRF does not appear to affect the development of post-traumatic osteoarthritis within 2 years follow-up in a small pilot cohort. Therapeutic II.

Comparison Between Multisite Injection and Single Rotator Interval Injection of Corticosteroid in Primary Frozen Shoulder (Adhesive Capsulitis): A Randomized Controlled Trial

BACKGROUND: Steroid injection is a commonly used conservative treatment for primary frozen shoulder (PFS), but the optimal injection site remains undetermined. OBJECTIVES: We conducted a prospective randomized controlled trial of multisite combined injection (MCI) vs single rotator interval injection (SRI). STUDY DESIGN: A randomized double-blinded controlled trial. SETTING: Center for Joint Surgery, Department of Orthopaedic Surgery, the Second Affiliated Hospital of Chongqing Medical University. METHODS: Sixty-four patients with PFS were randomly assigned to 2 groups. The experimental group received MCI in the rotator interval, intraarticular, and subacromial bursa; the control group received an SRI. Both groups were injected with one mL of 40 mg triamcinolone acetonide and 4 mL of 2% lidocaine. The injection process was completed under ultrasound guidance. Follow-up points were 4, 8, and 12 weeks postinjection. The outcome measures included the Visual Analog Scale (VAS) score, the American Shoulder and Elbow Surgeons (ASES) score, the Constant-Murley Shoulder (CMS) score, passive range of motion of the shoulder, and patient satisfaction rating. RESULTS: Thirty patients in the MCI group and 29 patients in the SRI group were included in the data analysis. All the outcomes in the 2 groups were significantly better postinjection than preinjection. The MCI group had a lower VAS score than the SRI group at 4 weeks (3.1 ± 1.2 vs 4.3 ± 1.6) and 8 weeks (2.2 ± 1.2 vs. 3.4 ± 1.2) (P < 0.05). Compared with the SRI group, the MCI group had a significant improvement in flexion and abduction (P < 0.01). Additionally, the ASES and CMS scores in the MCI group were better than those in the SRI group at 4, 8 and 12 weeks (P < 0.01). LIMITATIONS: Limitations include the sample size of this study is small and a that it was conducted at a single-center. CONCLUSIONS: Both MCI and SRI effectively alleviated pain and restored range of motion in patients with PFS. However, the MCI group had obviously lower early pain scores, better flexion and abduction, and better function scores than the SRI group; no additional adverse events were observed. KEY WORDS: Primary frozen shoulder, adhesive capsulitis, steroid injection, rotator interval, intraarticular, subacromial bursa

Ultrasonography Changes Following Single Intra-articular Corticosteroid Injection in Knee Osteoarthritis- A Randomized Controlled Trial

Ultrasonography Changes Following Single Intra-articular Corticosteroid Injection in Knee Osteoarthritis- A Randomized Controlled Trial

National Benchmarks for the Efficacy of Trigger Finger and the Risk Factors Associated With Failure.

The purpose of this study was to compare the efficacy of single and multiple corticosteroid injections used for symptomatic trigger finger. The rates of subsequent injections and the rate of tendon sheath release are reported along with the identification of risk factors correlated with failure of injection. A retrospective review of a national healthcare database was conducted identifying patients with a diagnosis of trigger finger or thumb. Inclusion required a tendon sheath injection on the same day or within six weeks of diagnosis. Patient cohorts were further stratified based on treatment success and those requiring additional injections within 6 months or surgery within 1 year of initial diagnosis. Thirty-one thousand seven hundred fifty-one patients met inclusion criteria and underwent an initial injection within the study period. The efficacy of initial, second, and third injection was 66.3%, 79.4%, and 79.6%, respectively. Of the patients who failed an injection, 9.4% had tendon sheath release after a primary injection, 23.1% had surgery after a second injection, and 30.4% had surgery after a third injection. Only obesity (OR 1.2; P < 0.0001) and concomitant diagnosis of carpal tunnel syndrome (OR 1.4; P < 0.0001) were found to be significant for injection failure on multivariate logistic regression analysis. Overall corticosteroid injections were effective in greater than 65% of patients. This information may help guide treatment practice because there seems to be continued additional benefit to repeat corticosteroid injections after injection failure.

A Comparative Study between Single Dose Intralesional Corticosteroid and PRP Injection in Chronic Plantar Fascitis - A Long Term Follow-Up Study

A Comparative Study between Single Dose Intralesional Corticosteroid and PRP Injection in Chronic Plantar Fascitis - A Long Term Follow-Up Study

A comparative study of single intra-articular platelet-rich plasma versus corticosteroid injection in the treatment of adhesive capsulitis of the shoulder

A comparative study of single intra-articular platelet-rich plasma versus corticosteroid injection in the treatment of adhesive capsulitis of the shoulder

Comparison of Clinical and Functional Outcomes after Platelet-Rich Plasma Injection and Corticosteroid Injection for the Treatment of de Quervain's Tenosynovitis.

Background Platelet-rich plasma (PRP) has local anti-inflammatory actions, which is being used as a treatment in various tendinopathies. Purpose The aim of the study is to compare the clinical results of PRP injection and corticosteroid injection in the management of de Quervain's tenosynovitis (DQTSV). Patients and Methods In this prospective study, 60 patients of DQTSV, fulfilling the predefined inclusion and exclusion criteria, were randomised into two groups. In group 1 ( n = 30), patients received a single injection of autologous PRP and in group 2 ( n = 30) they received a single injection of corticosteroid (methylprednisolone). All patients were followed up at 1 month, 3 months, 6 months, and 1 year for evaluation by Finkelstein test, visual analogue scale (VAS), DASH (Disabilities of the Arm, Shoulder and Hand) score, and Modified Mayo Wrist score (MMWS). Results In both the groups improvement occurred in Finkelstein test, VAS score, DASH score, and MMWS which were found to be statistically significant at all points of follow-ups when compared to the pre-intervention values. Comparison of scores between the two groups did not show any statistical significance. No complications were reported in PRP group. Statistically significant complications ( p -value = 0.026) like subcutaneous fat atrophy, depigmentation, and temporary increase in pain were seen in eight patients in the corticosteroid group with an overall complication rate of 26.67%. Conclusion Both the modalities are equally effective in the management of DQTSV remittance. PRP is equally effective as corticosteroid in reducing symptoms of first dorsal compartment stenosing tenosynovitis. PRP may have a lower complication profile, however, this benefit should be weighed against the slight increase in cost and time of PRP preparation and injection. Level of Evidence Level 2, prospective comparative study.

Effectiveness of single local corticosteroid injection in radial tunnel syndrome

Introduction: Radial tunnel syndrome (RTS) is an uncommon source of pain to the elbow and forearm often misdiagnosed as resistant tennis elbow. Corticosteroid injection is sometimes used in the management of radial tunnel syndrome, but has not been evaluated in depth.Aim and Objective: The purpose of this study was to evaluate the utility of corticosteroid injection as a therapeutic modality for the management of radial tunnel syndrome.Materials and Methods: We conducted this prospective study at G S medical College, Pilkhuwa, UP. The study period was from Jan 2022 to October 2022 which included follow up time of 6 months. The last case intervention was done in April 2022. A total of 30 patients (12 male and 18 female) were included with clinically diagnosed of radial tunnel syndrome.Results: Prior to intervention the mean qDASH was 51.7 points. The mean qDASH improved over time with significant decreases to 37.2 points, P = .03 and 29.9 points, P = .01 at 3 monts and 6 months follow-up respectively. The mean VAS for pain was 8.4 points prior to intervention and improved over time with significant decreases to 1.56 points, P = .005 and 1.7 points, P = .003 at 3 months and 6 months follow-up respectively. There were no complications from injection.Conclusion: Corticosteroid injection in patients with RTS was a safe procedure that gave very good preliminary results for symptom relief.

Evaluation of the Treatment Efficacy of Corticosteroid Injection in Reducing the Pain Intensity in the Patients Diagnosed with the Plantar Fasciitis

Background: Plantar fasciitis is an orthopedic ailment that affects athletes and non-athletes equally. The 10% of the general population attend the orthopedic surgeons with heel pain in their lifetime. The degenerative changes in plantar fasciitis worsen the conditions of patients. Objective: The study aimed to evaluate the treatment efficacy of corticosteroid injection in reducing the pain intensity in the patients clinically diagnosed with the plantar fasciitis. Study design: This descriptive study was conducted on 40 patients who attended the orthopedics department of Lady Reading Hospital Peshawar. The duration of study was one year from April 2021 to March 2022. Material and Methods: The patients who were clinically diagnosed with the plantar fasciitis and met the inclusion criteria were selected for the study. The study was approved by the ethical and review board committee of the hospital. The selected patients were administrated with the Triamcinolone injection in the heel. The visual analog scale was used to assess the outcomes. The data was collected and SPSS was used for the statistical analysis. Results: The total 40 patients were selected for the study. The mean calculated age was 42.83± 7.07. Out of 40 patients the (22) 55% were male and remaining (18) 45% were female. The mean pre injection VAS improved from 6.30±2.1 to 1.5±6 post injection. The p-value was 0.03. Conclusion: It was concluded that the single injection of corticosteroid significantly reduce the pain intensity associated with plantar fasciitis. Keywords: Triamcinolone injection and visual analog scale.

Perceived Pain Severity and Disability After the Recurrence of Tennis Elbow Following a Local Corticosteroid Injection.

We hypothesized that there is no difference in the perceived pain and disability when the tennis elbow symptoms recur after a corticosteroid injection (CSI). Consequently, we secondarily aimed to assess the approximate time from CSI until symptom recurrence. Moreover, we aimed to evaluate factors associated with the time to recurrence. This cross-sectional study was performed during 2018-2019. We enrolled 50 consecutive patients who presented with the recurrence of tennis elbow symptoms and had a history of a single CSI for this condition. We asked the patients to rate the perceived pain and disability by filling the QuickDASH twice, including one by recalling pain and function before the CSI and one for the recent recurrent symptoms to assess the patient's perceived pain and disability at the two-time points. There was a significant difference in perceived pain VAS and disability QuickDASH between pre-injection and recurrence, showing that the patient's perceived pain and disability were greater when recurred (P<0.001). The mean time between CSI and recurrence of symptoms was 6 (4-7) months, which is shorter than the expected spontaneous resolution of tennis elbow (> 1 year) to offer other invasive treatments. Time to recurrence had no significant association with sex, age, side, education, occupation, pre-injection VAS score, pre-injection QuickDASH, or symptom duration using a linear regression model. Although CSI seems to relieve or mask the pain in the short term, there is a considerable chance of recurrence, and patients may perceive more significant pain and disability that may lead to subsequent injection or precocious surgery. Time is an effective treatment for this illness. Shared decision-making is paramount, and patients have to be counseled regarding the natural history and expected prognosis of different treatments.

Treatment of chronic plantar fasciitis: a comparative study between shockwave therapies and local corticosteroid injection

Introduction One of the most prevalent ailments for which people seek treatment at a foot and ankle surgery facility is heel discomfort. Plantar fasciitis (PF) is one of the most common causes of adult heel pain and accounts for 11 to 15 % of all foot illnesses requiring medical care. The major symptom is pain and soreness at the heel where the plantar fascia is attached while starting weight- bearing after lengthy periods of rest. Rest, non-steroidal anti-inflammatory drugs (NSAIDs), stretching of the plantar fascia, physical therapy, foot cushioning, and orthotic devices, which may be utilized to meet the patient's demands, are some of the current conservative therapies for PF(planter fasciitis). In intractable instances of plantar fasciitis, where conservative therapy have failed to provide relief, steroid injections into the plantar fascia are often employed. Other treatment options for PF, including extracorporeal shockwave therapy (ESWT) are advised if patients do not react to conservative therapies. Patients and methods This study included 50 patients with chronic PF who had failed to react to conservative treatments such as physical therapy, NSAIDs, stretching exercises, and heel cushions for at least 6 months, and who did not have flatfeet or gastrocnemius contracture met the inclusion criteria. Patients were randomly divided into 2 groups: 25 patients received radial extracorporeal shockwave therapy (ESWT) once a week for six weeks (Group I); 25 patients got a single local corticosteroid injection at the plantar fascia's origin (40 mg / 2 ml of methylprednisolone together with 1 ml of local anesthesia, once) (Group II). Assessment of heel pain was done at the start of the trial and before each session using VAS score which was the primary outcome measure at 1, 3 and 6 months. Results A total of 50 individuals with persistent planter fasciitis (PF) were included in this investigation. Their age varied from 25 to 45 years old. Females made up 70 % of the sample, while males made up 30 %. Group I: 25 patients with PF who got extracorporeal shockwave treatment for 6 weeks at a time (once a week). There were 17 females (68 %) and 8 males (32 %), in the age ranging from 28 to 44 (mean SD 18.2).Group II: consisted of 25 individuals with PF who were given a local corticosteroid injection. There were 18 females (86.7 percent) and 7 males (13.3 percent) with ages ranging from 25 to 45 years (mean SD 21.9). Group I included 20 patients (80 %) and group II had 22 patients (88 %) who had pain in one foot, whereas 5 (20 %) patients and 3 (12 %) patients had pain in both feet, with no statistically significant difference. There was no significant difference between the groups in terms of the VAS score at the start of the trial (p = 0.26), the mean VAS scores were 6.4 and 6.2 in groups I and II, respectively. At one month, the mean VAS scores were 1.6 and 1.2 in group I and II, respectively. At 3 months, the mean VAS score were 2.2 and 1.7, at 6 months 5.1 and 2.3 for groups I and II, respectively. Conclusion ESWT and local corticosteroid injection therapies are safe and effective but local corticosteroid injection is more effective than ESWT in the treatment of chronic plantar fasciitis.

Corticosteroid injections 2months before arthroscopic meniscectomy increases the rate of postoperative infections requiring surgical irrigation and debridement.

Consensus guidelines recommend administering a corticosteroid injection (CSI) for patients with a symptomatic degenerative meniscus lesion prior to arthroscopic partial meniscectomy (APM). A recent study found that CSI administered within 1month prior to meniscectomy is associated with an increased risk of postoperative infection. However, infections may range in severity from superficial infections to serious infections requiring surgical interventions. The aim of this analysis was to define the rate of infections requiring surgery after APM and determine its relationship to preoperative CSI. The PearlDiver Mariner administrative claims database was queried for patients > 35years old who had a CSI in the year prior to isolated APM. Rates of deep infection and infection requiring surgery within 6months were reported between matched patients with a CSI and no injection. After matching, there were 16,009 patients per group with a mean age of 59.4years (SD = 9.6), 53.5% obesity, and 40% male. Forty-four of 113 patients who developed a postoperative deep infection went on to have a reoperation for irrigation and/or debridement (0.1% of all APM). Of these 44 patients, 30 had a preoperative CSI and 14 were controls unadjusted odds ratio (unadj-OR) if given CSI = 1.95, 95% CI 1.03-3.68, P = 0.04). Having a CSI within the month before surgery conferred a 4.56-fold increase in odds of an infection warranting surgery (95% CI 1.96-10.21, P < 0.01), whilst having a CSI 4-8weeks before surgery conferred a 2.42-fold increase in odds (95% CI 1.04-5.42, P = 0.03). Receiving multiple CSI in the year prior to APM was associated with 5.27-fold increased odds of an infection requiring surgery (95% CI 1.19-23.27, P = 0.03), compared to having a single CSI. Serious infections requiring a surgical intervention are rare after a meniscectomy, occurring in 0.1% of APMs in a matched cohort of patients over 35. Patients were five times more likely to return to the operating room for infection after APM if they had a CSI in the month before or had multiple CSIs in the year before surgery. The risk of infection was no longer significant if there was at least a 2-month interval between preoperative CSI and APM. Level III.

Role of suprascapular nerve block in idiopathic frozen shoulder treatment: a clinical trial survey.

BackgroundSeveral therapeutic methods have been proposed for frozen shoulder syndrome. These include suprascapular nerve block, a simple and cost-effective technique that eliminates the need for nonsteroidal anti-inflammatory drug therapy.MethodsThis was a clinical trial that included patients with unilateral shoulder joint stiffness. Patients were divided into three groups: those treated with isolated physiotherapy for 12 weeks (PT group), those treated with a single dose intra-articular injection of corticosteroid together with physiotherapy (IACI group), and those treated with a suprascapular nerve block performed with a single indirect injection of 8-mL lidocaine HCL 1% and 2 mL (80 mg) methylprednisolone acetate together with physiotherapy (SSNB group). The variables assessed were age, sex, side of involvement, dominant limb, presence of diabetes, physical examination findings including erythema, swelling, and muscle wasting; palpation and movement findings; shoulder pain and disability index (SPADI) score; and the visual analog scale (VAS) score pre-intervention and at 2-, 4-, 6-, and 12-week post-intervention.ResultsNinety-seven patients were included in this survey (34 cases in the PT group, 32 cases in the IACI group, and 31 cases in the SSNB group). Mean age was 48.55±11.06 years. Fifty-seven cases were female (58.8%) and 40 were male (41.2%). Sixty-eight patients had a history of diabetes (70.1%). VAS and SPADI scores and range of mototion degrees dramatically improved in all cases (p<0.001). Results were best in the SSNB group (p<0.001), and the IACI group showed better results than the PT group (p<0.001).ConclusionsSuprascapular nerve block is an effective therapy with long-term pain relief and increased mobility of the shoulder joint in patients with adhesive capsulitis.

Effectiveness of Corticosteroid Injections in Diabetic Patients With De Quervain Tenosynovitis

We sought to determine the effectiveness of corticosteroid injections (CSIs) for de Quervain tenosynovitis in patients with diabetes mellitus. We retrospectively identified all patients with diabetes receiving a CSI for de Quervain tenosynovitis by 16 surgeons over a 2-year period. Data collected included demographic information, medical comorbidities, number and timing of CSIs, and first dorsal compartment release. Success was defined as not undergoing an additional CSI or surgical intervention. The mixture of a corticosteroid and local anesthetic provided in each injection was at the discretion of each individual surgeon. Corticosteroid injections were given to 169 wrists in 169 patients with diabetes. Out of 169 patients, 83 (49%) had success following the initial CSI, 44 (66%) following a second CSI, and 6 (67%) following a third CSI. A statistically significant difference was identified in the success rates between the first and second CSIs. Ultimately, 36 of 169 wrists (21%) underwent a first dorsal compartment release. Patients with diabetes mellitus have a decreased probability of success following a single CSI for de Quervain tenosynovitis in comparison to nondiabetic patients, as described in the literature. However, the effectiveness of each additional CSI does not appear to diminish. Therapeutic IV.