Study On The Effect Of Ultrasound-Guided Hydrolysis Of Glenohumeral Joint Capsule On Frozen Shoulder

Objective: Ultrasound elastography was used to evaluate the effect of ultrasound-guided hydraulic release of glenohumeral articular capsule on different types of frozen shoulder.Methods: The frozen shoulder patients who went to the Second Affiliated Hospital of Inner Mongolia Medical University were selected.The patients who met the diagnosis of frozen shoulder in clinical signs,VAS and ROM scores,and imaging were selected.Blood samples were taken to test glycosylated hemoglobin as the standard to distinguish diabetes frozen shoulder and primary frozen shoulder.The patient signed the informed consent form for the operation before the operation and recorded the file.All the subjects were examined when the shoulder was in a neutral position(the upper arm was kept below the midline of the armpit,without abduction,adduction,external rotation or internal rotation).Before the operation,the hardness of soft tissues around the shoulder joint capsule,including the coracobrachial ligament,supraspinatus muscle,trapezius muscle and the descending capsule of the deltoid peak,was measured by ultrasonic elastic imaging technology,and the average value was taken and recorded three times in the area of interest(as shown in the figure).At the 3rd,6th and 12 th weeks after the ultrasound-guided hydrolysis of the glenohumeral joint capsule,the soft tissue around the shoulder joint capsule,the coracobrachial ligament,the supraspinatus muscle,the trapezius muscle and the lower deltoid muscle,the hardness value of the descending capsule of the shoulder peak,and the VAS and ROM scores of the shoulder joint were measured and recorded.In order to ensure the reliability and repeatability of ultrasound diagnosis results and ultrasound intervention treatment,all cases were completed by doctors with strict and standardized training.Results: During the study,there were 2 cases of separation,1 case in the primary group,1case in the diabetes group,and the remaining 178 cases were included in the statistics,89 cases in the primary group,and 89 cases in the diabetes group.1.General information: There is no significant difference in gender,age,duration of disease course between the primary group and the diabetes group(P>0.05),which is comparable.2.VAS score: The VAS score of the two groups before and after treatment was significantly lower than that before treatment at3,6 and 12 weeks after treatment(P<0.05).Compared between the two groups,there was no significant difference in VAS scores before treatment between the primary group and the diabetes group(P>0.05),which was comparable.There was no significant difference between the two groups 3 weeks after treatment,which was not statistically significant(P>0.05).After6 and 12 weeks of treatment,the VAS scores of the primary group decreased more significantly than those of the diabetes group,which was statistically significant(P<0.05).3.ROM of the shoulder joint: Compared with the two groups before and after treatment,the range of motion of the shoulder joint in all directions increased at 3,6 and 12 weeks after treatment,with statistical significance(P<0.05).Compared between the two groups,there was no significant difference between the primary group and the diabetes group in the range of motion of the shoulder joint in all directions before treatment,which was not statistically significant(P>0.05).It was comparable.There was no significant difference between the primary group and the diabetes group in the range of motion of the shoulder joint in all directions 3 weeks after treatment,which was not statistically significant(P>0.05).After 6and 12 weeks of treatment,the angle of flexion,abduction,external rotation and internal rotation of the shoulder joint in the primary group was significantly improved than that in the diabetes group,There was statistical significance(P<0.05).4.Young’s modulus E value: as shown in Table 3-3,the hardness values of coracobrachial ligament,supraspinatus muscle,bursa,and trapezius muscle of the two groups before and after treatment were lower than those before treatment(P<0.05).Compared between the two groups,the hardness values of coracobrachial ligament,supraspinatus muscle,bursa and trapezius muscle before treatment in the primary group and the diabetes group were not significantly different(P>0.05),which was comparable.The hardness values of coracobrachial ligament,supraspinatus muscle and trapezius muscle in the primary group were significantly lower than those in the diabetes group 3,6 and 12 weeks after treatment,which was statistically significant(P<0.05).The hardness values of bursa in the primary group and the diabetes group had no significant difference 3 and 6 weeks after treatment,There was no statistical significance(P>0.05).The hardness of the bursa in the primary group was significantly lower than that in the diabetes group 12 weeks after treatment(P<0.05).Conclusions: The ultrasonic elastic imaging technology can quantitatively evaluate the changes of hardness values of soft tissues around the shoulder articular capsule,including Coracohumeral ligament,supraspinatus muscle,bursa,trapezius muscle before and after the treatment of primary frozen shoulder and diabetes frozen shoulder glenohumeral articular capsule hydraulic release.The hardness changes of primary frozen shoulder are better than those of diabetes frozen shoulder after treatment,which can provide quantitative evaluation criteria for clinical efficacy,and is worth clinical promotion.