Intra-articular versus periarticular acromioclavicular joint injection: a multicenter, prospective, randomized, controlled trial

Arthroscopy. 2013 Dec;29(12):1903-10. doi: 10.1016/j.arthro.2013.08.027. Epub 2013 Oct 18.

Abstract

Purpose: The purpose of this randomized study was to compare the clinical efficacy of intra-articular versus periarticular acromioclavicular joint injections.

Methods: In this multicenter, prospective, randomized, controlled trial, 101 patients (106 shoulders) with symptomatic acromioclavicular joints were treated with an injection and were randomly assigned to either the intra-articular group or the periarticular group. To ensure accurate needle placement either intra-articularly or in a periarticular manner, the needle was placed under ultrasound guidance. Baseline values including the Constant-Murley score, pain assessment with a visual analog scale for pain under local pressure and pain at night, and the crossover arm test were investigated in 7 different centers immediately before treatment. Follow-up examinations were scheduled after 1 hour, 1 week, and 3 weeks.

Results: All patients completed the study. Overall, a highly significant clinical improvement in all tested variables and in both groups was observed over time (P < .0001) beginning with 1 hour after treatment and lasting for the entire follow-up period of 3 weeks. The difference between the 2 groups was not significant except regarding the crossover arm test (P < .016).

Conclusions: With both injection techniques, a highly significant clinical advantage for the patient can be achieved. The difference between the 2 treatments was not significant except for more pain reduction according to the crossover arm test after intra-articular injection at 3 weeks' follow-up.

Level of evidence: Level II, multicenter, randomized, prospective, controlled trial.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acromioclavicular Joint* / physiopathology
  • Arthralgia / diagnosis
  • Arthralgia / etiology
  • Arthralgia / prevention & control
  • Female
  • Hematoma / etiology
  • Humans
  • Injections, Intra-Articular / adverse effects
  • Injections, Intra-Articular / methods*
  • Male
  • Middle Aged
  • Osteoarthritis / drug therapy*
  • Pain Measurement
  • Prospective Studies
  • Range of Motion, Articular
  • Treatment Outcome