| Objective By using ultrasound imaging to measure the thickness of CHL and IC quantitatively,the therapeutic effect of glenohumeral articular capsule hydraulic release on diabetes frozen shoulder and primary frozen shoulder was evaluated,and the safety and effectiveness of glenohumeral articular capsule hydraulic release on frozen shoulder were evaluated based on the realization of ultrasound imaging.Methods Thirty patients with primary frozen shoulder and 30 patients with diabetes frozen shoulder diagnosed in the Second Affiliated Hospital of Inner Mongolia Medical University from December 2021 to October 2022 were selected and divided into primary group and diabetes group.Both groups of patients volunteered to perform ultrasound-guided hydraulic release of the glenohumeral articular capsule.The method was that ultrasound-guided puncture needle entered the glenohumeral articular capsule,subacromial space,and rotator cuff space,injected liquid through the syringe,and released the internal and external adhesion of the articular capsule through the mechanical pressure of the liquid and medicinal chemistry.Three consecutive treatments were performed in the first,second,and fourth weeks.All ultrasound-guided hydraulic expansion of the shoulder articular capsule were performed by the same team of physicians with more than 3 years of experience in musculoskeletal ultrasound intervention treatment,and were followed up for 6 months.The thickness of the axillary articular capsule(IC)and the thickness of the Coracohumeral ligament(CHL)were measured by ultrasonic measurement software before,2 weeks,3 months and 6 months after the treatment of frozen shoulder in the primary group and the diabetes group.The clinical evaluation indexes VAS(Visual Analogue Scale)and AROM(Active Range of Shoulder Motion)were used to evaluate the effects of the two groups before and after treatment.Intra and inter group statistical analysis was conducted on the IC thickness value,CHL thickness value,VAS score,and AROM score of two groups of frozen shoulder patients before and after treatment.The monitoring indicators were statistically analyzed using SPSS.22 software,and the measurement data were subjected to normality tests.Two independent sample t-tests were used for inter group comparisons,paired t-tests were used for intra group comparisons,and repeated measurement variance analysis was used for clinical related indicators at different time points before and after treatment.P<0.05 indicates that the difference is statistically significant.Analyze whether there is a correlation between ultrasound indicators and clinical indicators using Pearson correlation analysis.Results(1)There was no significant difference in the general information of the two groups of patients:among the patients in this study,there was no statistical significance in the age,gender,and shoulder side of the patients in the primary group and the diabetes group(P>0.05).(2)Comparison of VAS,AROM scores,CHL thickness,and IC thickness between two groups of patients:①There was no statistically significant difference in the CHL thickness,IC thickness,VAS score,and AROM score of the shoulder joint between the two groups of patients before treatment(P>0.05).②The IC thickness and CHL thickness in the primary group at 2 weeks,3 months and 6 months after treatment were statistically significant compared with those in the diabetes group(P<0.05).The VAS score and AROM score in the primary group were significantly higher than those in the diabetes group 2 weeks and 3 months after treatment(P<0.05).③There was no significant difference in VAS score and AROM score between the primary group and the diabetes group 6 months after treatment(P>0.05).(3)Correlation between VAS,AROM scores,CHL thickness,and IC thickness within the primary frozen shoulder group:①After hydraulic release treatment,the IC thickness value,CHL thickness value,and VAS score in the primary group decreased compared to before treatment(P<0.001),while the AROM score increased compared to before treatment(P<0.001).② There was a statistically significant difference in IC thickness,CHL thickness,VAS score,and AROM score between 3 and 6 months after treatment and 2 weeks after treatment(P<0.05).③ There was no statistically significant difference in IC thickness,CHL thickness,VAS score,and AROM score between 3 months after treatment and 6 months after treatment(P>0.05).(4)Comparison of VAS and AROM scores with CHL thickness and IC thickness in the diabetes frozen shoulder group:① After treatment,the IC thickness value,CHL thickness value,and VAS score decreased compared to before treatment(P<0.001),while the AROM score increased compared to before treatment(P<0.001).② The IC thickness,CHL thickness,VAS score,and AROM score at 3 and 6 months within the group were compared with those at 2 weeks after treatment,and the differences were statistically significant(P<0.05).③ There was no statistically significant difference in the IC thickness and CHL thickness values at 3 months within the group compared to 6 months(P>0.05).④There was a statistically significant difference in VAS score and AROM score at 3 months within the group compared to 6 months(P<0.05).(5)Correlation analysis between ultrasound measurement indicators(IC,CHL)and clinical evaluation indicators(VAS,AROM):① The IC thickness value after treatment was positively correlated with VAS score,and the difference was statistically significant(r=0.923,P<.001);② The CHL thickness value after treatment was positively correlated with VAS score,and the difference was statistically significant(r=0.824,P<.001);③ The IC thickness value after treatment was negatively correlated with the AROM score,and the difference was statistically significant(r=-0.421,P<.001);④The CHL thickness value after treatment was negatively correlated with the AROM score,and the difference was statistically significant(r=-0.285,P<.001).Conclusion(1)Ultrasound guided hydraulic release of glenohumeral articular capsule for the treatment of primary frozen shoulder and diabetes frozen shoulder has higher safety and effectiveness,and the efficacy of primary frozen shoulder is better than diabetes frozen shoulder.(2)The frozen shoulder in the primary group achieved the best treatment effect 3 months after treatment,and the ultrasound measurement indicators were consistent with the clinical evaluation indicators.(3)Ultrasonic imaging can be used as the main body to evaluate the clinical effect of frozen shoulder and glenohumeral articular capsule hydraulic release in the treatment of frozen shoulder... |
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