Efficacy Analysis Of Ultrasound-guided Pulsed Radiofrequency Of The Suprascapular And Axillary Nerves In The Treatment Of Rotator Cuff Injury

Objective:To study the effectiveness of ultrasound-guided pulsed radiofrequency of the suprascapular and axillary nerves combined with steroid injection in the treatment of rotator cuff injury.Methods:A total of 42 patients with rotator cuff injury,47 affected shoulders,were included and randomly divided into 2 groups.In the control group,there were 25 patients with 26 affected shoulders,and 20 ml of anti-inflammatory and analgesic solution(1 ml of DIPROSPAN+4 ml of 2%lidocaine+15 ml of saline)was injected into the rotator cuff interval for 2 times with an interval of 2 weeks;in the combined group,there were 20 patients with 21 affected shoulders,and the combined group underwent ultrasound-guided pulsed radiofrequency of the suprascapular and axillary nerves and rotator cuff interval injection.The primary outcome were the changes of Numerical Rating Scale(NRS)of resting and active pain before,2 weeks,4 weeks,3 months and 6 months after treatment in the two groups,and the secondary outcome were the changes of active and passive range of motion(Range of Motion,ROM;Active ROM,AROM;Passive ROM,PROM)of the shoulder joint before and 2 weeks and 4 weeks after treatment in the two groups,Constant-Murley Score(CS),and whether the magnitude of change in NRS and CS reached the Minimal Important Difference(MID),and whether the NRS and CS reached Patient Acceptable Symptom State(PASS)after treatment.Results:1.By the end of the study,resting and active NRS were significantly reduced in both groups at all time points after treatment compared with pre-treatment(P<0.05),and active NRS were better in the combined group than in the control group(P<0.05),and resting NRS at 3 months after treatment and active NRS at 6 months of treatment were better in the combined group than in the control group(P<0.05).2.The combined group was better than the control group in terms of improvement in passive abduction and passive external rotation angles(P<0.05),active external rotation and active internal rotation only differed between the combined group before and after treatment(P<0.05),and active external rotation and active internal rotation showed superiority between the combined group and the control group at 4 weeks after treatment(P<0.05),and the rest of activity was not different between the two groups(P>0.05).3.The CS of the combined group was significantly better than that of the control group(P<0.05).4.Both groups reached the predetermined MID at all time points after treatment;the resting NRS score in the combined group reached PASS at 2 and 4 weeks after treatment,the CS in the control group reached PASS at 4 weeks after treatment,and the combined group reached PASS at 2 and 4 weeks after treatment.Conclusion:Ultrasound-guided of the suprascapular and axillary nerves combined steroid injections can rapidly reduce pain and keep it low in patients with rotator cuff injuries,while improving shoulder function,especially in abduction(PROM)and external rotation(PROM)mobility.