Ultrasound-guided hydrodistension for adhesive capsulitis: a longitudinal study on the effect of diabetes on treatment outcomes,Skeletal Radiology

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Ultrasound-guided hydrodistension for adhesive capsulitis: a longitudinal study on the effect of diabetes on treatment outcomes
Skeletal Radiology ( IF 1.9 ) Pub Date : 2022-07-30 , DOI: 10.1007/s00256-022-04141-2
Sofia Dimitri-Pinheiro _{1,

2} , Michail E Klontzas _{3,

4} , Madalena Pimenta ₅ , Evangelia E Vassalou ₃ , Raquel Soares _{2,

6} , Apostolos H Karantanas _{3,

4}

Affiliation

Objective

The effect of diabetes on adhesive capsulitis (AC) and its impact on the outcomes of ultrasound (US)-guided hydrodistension of the glenohumeral joint are still unclear. We aimed to identify predictors of US-guided hydrodistension outcomes, while assessing the performance of the method in diabetic compared to non-diabetic patients.

Materials and methods

A total of 135 patients with AC who underwent US-guided hydrodistension were prospectively included. Demographics and factors linked to chronic inflammation and diabetes were recorded and patients were followed-up for 6 months. Functionality and pain were evaluated with the Disabilities of the Arm, Shoulder and Hand (DASH) and the Visual Analogue Scale (VAS) score. Statistical analysis was performed with Mann–Whitney U test, linear, and binary logistic regression.

Results

Diabetes was identified in 25/135 patients (18.5%). Diabetic patients had worse DASH and VAS score at presentation (P < 0.0001) and presented with a higher grade of AC (P < 0.0001) and lower range of motion (P < 0.01) compared to non-diabetics. Higher DASH (P = 0.025) and VAS scores (P = 0.039) at presentation were linked to worse functionality at 6 months. Presence and duration of diabetes, and the number of hydrodistension repeats, correlated with worse VAS and DASH scores at 6 months. The number of procedure repeats was the only independent predictor of complete pain resolution at 6 months (OR 0.418, P = 003).

Conclusion

Diabetes is linked to more severe AC at presentation and worse outcomes in patients undergoing US-guided hydrodistension. In resistant cases, repeating the intervention is independently linked to worse outcomes for at least 6 months post-intervention.

中文翻译：

超声引导下水肿扩张治疗粘连性囊炎：一项关于糖尿病对治疗结果影响的纵向研究

客观的

糖尿病对关节囊粘连 (AC) 的影响及其对超声 (US) 引导的盂肱关节积水扩张术结果的影响仍不清楚。我们的目的是确定超声引导下水肿结果的预测因子，同时评估该方法在糖尿病患者和非糖尿病患者中的表现。

材料和方法

前瞻性纳入了总共 135 名接受超声引导下水扩张术的 AC 患者。记录了与慢性炎症和糖尿病相关的人口统计学和因素，并对患者进行了 6 个月的随访。使用手臂、肩部和手部残疾 (DASH) 和视觉模拟量表 (VAS) 评分评估功能和疼痛。使用 Mann-Whitney U检验、线性和二元逻辑回归进行统计分析。

结果

25/135 名患者 (18.5%) 被确诊为糖尿病。与非糖尿病患者相比，糖尿病患者在就诊时的 DASH 和 VAS 评分较差 ( P < 0.0001)，并且 AC 等级较高 ( P < 0.0001) 且运动幅度较低 ( P < 0.01)。就诊时较高的 DASH ( P = 0.025) 和 VAS 评分 ( P = 0.039) 与 6 个月时较差的功能有关。糖尿病的存在和持续时间以及水肿重复的次数与 6 个月时较差的 VAS 和 DASH 评分相关。手术重复次数是 6 个月时疼痛完全消退的唯一独立预测因子（OR 0.418，P = 003）。