Intra-articular Glucose Injections for Orthoregeneration of Frozen Shoulder. A Clinical Case.
Main Article Content
Abstract
Frozen shoulder or adhesive capsulitis is a difficult to treat disorder characterized by pain and loss of movement. Novel therapies such as hydraulic distension with orthobiologics may improve outcomes among individuals with this debilitating condition. The clinical case in this article describes the treatment of a patient with frozen shoulder using a series of joint injections using high volumes of sugar water. The positive outcome of this novel injection technique is an invitation to design clinical trials using orthobiologics for frozen shoulder.
Keywords:
adhesive capsulitis, frozen shoulder, intra-articular injections, orthobiologics, prolotherapy, capsule-preserved hydraulic distension, glucose, dextrose, intra-articular steroids, hydrodilatation
Article Details
How to Cite
KERSSCHOT, Jan.
Intra-articular Glucose Injections for Orthoregeneration of Frozen Shoulder. A Clinical Case..
Medical Research Archives, [S.l.], v. 11, n. 8, aug. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4276>. Date accessed: 29 apr. 2024.
doi: https://doi.org/10.18103/mra.v11i8.4276.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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3. Redler LH, Dennis ER. Treatment of Adhesive Capsulitis of the Shoulder. J Am Acad Orthop Surg. 2019;27(12):e544-e554.
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5. Ramirez J. Adhesive Capsulitis: Diagnosis and Management. Am Fam Physician. 2019; 99(5):297-300
6. Struyf F, Meeus M. Current evidence on physical therapy in patients with adhesive capsulitis: what are we missing? Clin Rheumatol. 2014;33(5):593-600
7. Horst R, Maicki T, Trąbka R, Albrecht S, Schmidt K, Mętel S, von Piekartz H. Activity- vs. structural-oriented treatment approach for frozen shoulder: a randomized controlled trial. Clin Rehabil. 2017;31(5):686-695
8. Chan HBY, Pua PY, How CH. Physical therapy in the management of frozen shoulder. Singapore Med J. 2017;58(12):685-689
9. Page MJ, Green S, Kramer S, Johnston RV, McBain B, Chau M, Buchbinder R. Manual therapy and exercise for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev. 2014;(8):CD011275
10. Davies C, The Frozen Shoulder Workbook, New Harbinger Publications 2006
11. Sung JH, Lee JM, Kim JH. The Effectiveness of Ultrasound Deep Heat Therapy for Adhesive Capsulitis: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022;19(3):1859
12. Weiss JJ, Ting YM. Arthrography-assisted intra-articular injection of steroids in treatment of adhesive capsulitis. Arch Phys Med Rehabil. 1978;59(6):285-7
13. Millar NL, Meakins A, Struyf F, Willmore E, Campbell AL, Kirwan PD, Akbar M, Moore L, Ronquillo JC, Murrell GAC, Rodeo SA. Frozen shoulder. Nat Rev Dis Primers. 2022;8(1):59
14. Sun Y, Lu S, Zhang P, Wang Z, Chen J. Steroid Injection Versus Physiotherapy for Patients With Adhesive Capsulitis of the Shoulder: A PRIMSA Systematic Review and Meta-Analysis of Randomized Controlled Trials. Medicine (Baltimore). 2016;95(20):e3469
15. Tafti D, Schultz D. Shoulder Joint Injection. 2023 May 22. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. PMID: 32644744.
16. Lin CY, Huang SC, Tzou SJ, Yin CH, Chen JS, Chen YS, Chang ST. A Positive Correlation between Steroid Injections and Cuff Tendon Tears: A Cohort Study Using a Clinical Database. Int J Environ Res Public Health. 2022;19(8):4520
17. McAlindon TE, LaValley MP, Harvey WF, Price LL, Driban JB, Zhang M, Ward RJ. Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. JAMA. 2017;317(19):1967-1975
18. Lemos SE. Editorial Commentary: Periarticular and Intra-Articular Injections May Do the Right Thing for Patients' Pain but May Be the Wrong Thing for Their Articular Cartilage: Be Careful. Arthroscopy. 2022; 38(6):1996-1998
19. Pereira H, Sousa DA, Cunha A, Andrade R, Espregueira-Mendes J, Oliveira JM, Reis RL. Hyaluronic Acid. Adv Exp Med Biol. 2018; 1059:137-153
20. Rossi LA, Piuzzi NS, Shapiro SA. Glenohumeral Osteoarthritis: The Role for Orthobiologic Therapies: Platelet-Rich Plasma and Cell Therapies. JBJS Rev. 2020; 8(2):e0075
21. Centeno CJ, Berger DR, Money BT, Dodson E, Urbanek CW, Steinmetz NJ. Percutaneous autologous bone marrow concentrate for knee osteoarthritis: patient-reported outcomes and progenitor cell content. Int Orthop. 2022;46(10):2219-2228
22. Centeno CJ, Al-Sayegh H, Bashir J, Goodyear S, Freeman MD. A prospective multi-site registry study of a specific protocol of autologous bone marrow concentrate for the treatment of shoulder rotator cuff tears and osteoarthritis. J Pain Res. 2015;8:269-76
23. Condron NB, Kester BS, Tokish JM, Zumstein MA, Gobezie R, Scheibel M, Cole BJ. Nonoperative and Operative Soft-Tissue, Cartilage, and Bony Regeneration and Orthopaedic Biologics of the Shoulder: An Orthoregeneration Network (ON) Foundation Review. Arthroscopy. 2021;37(10):3200-3218
24. Centeno C, Fausel Z, Stemper I, Azuike U, Dodson E. A Randomized Controlled Trial of the Treatment of Rotator Cuff Tears with Bone Marrow Concentrate and Platelet Products Compared to Exercise Therapy: A Midterm Analysis. Stem Cells Int. 2020;2020:5962354
25. Ünlü B, Çalış FA, Karapolat H, Üzdü A, Tanıgör G, Kirazlı Y. Efficacy of platelet-rich plasma injections in patients with adhesive capsulitis of the shoulder. Int Orthop. 2021;45(1):181-190
26. Mao B, Peng R, Zhang Z, Zhang K, Li J, Fu W. The Effect of Intra-articular Injection of Hyaluronic Acid in Frozen Shoulder: a Systematic Review and Meta-analysis of Randomized Controlled Trials. J Orthop Surg Res. 2022;17(1):128
27. Zhao AT, Caballero CJ, Nguyen LT, Vienne HC, Lee C, Kaye AD. A Comprehensive Update of Prolotherapy in the Management of Osteoarthritis of the Knee. Orthop Rev (Pavia). 2022;14(4):33921.
28. Martínez-Pizarro S. Prolotherapy with dextrose to reduce pain in osteoarthritis of the knee. Reumatol Clin (Engl Ed). 2022; 18(4):251-252.
29. Rabago D, Ralston B, Zaharoff A. Prolotherapy: An Evidence-Based Adjunctive Therapy for Knee Osteoarthritis. Am Fam Physician. 2021;103(7):395.
30. Cho JH. Updates on the treatment of adhesive capsulitis with hydraulic distension. Yeungnam Univ J Med. 2021;38(1):19-26
31. Chung SG, Lee KJ, Kim HC, Seo KS, Lee YT. Intra-articular pressure profiles of painful stiff shoulders compared with those of other conditions. PM R. 2009;1(4):297-307
32. Lee JH, Kim SB, Lee KW, Lee SJ, Lee JU. Effect of Hypertonic Saline in Intra-Articular Hydraulic Distension for Adhesive Capsulitis. PM R. 2015;7(7):721-726
33. Lee JH, Kim SB, Lee KW, Lee SJ, Lee JU. Effect of Hypertonic Saline in Intra-Articular Hydraulic Distension for Adhesive Capsulitis. PM R. 2015;7(7):721-726
34. Zhao AT, Caballero CJ, Nguyen LT, Vienne HC, Lee C, Kaye AD. A Comprehensive Update of Prolotherapy in the Management of Osteoarthritis of the Knee. Orthop Rev (Pavia). 2022;14(4):33921.
35. Martínez-Pizarro S. Prolotherapy with dextrose to reduce pain in osteoarthritis of the knee. Reumatol Clin (Engl Ed). 2022; 18(4):251-252.
36. Rabago D, Ralston B, Zaharoff A. Prolotherapy: An Evidence-Based Adjunctive Therapy for Knee Osteoarthritis. Am Fam Physician. 2021;103(7):395.
37. Wee TC, Neo EJR, Tan YL. Dextrose prolotherapy in knee osteoarthritis: A systematic review and meta-analysis. J Clin Orthop Trauma. 2021;19:108-117.
38. Arias-Vázquez PI, Tovilla-Zárate CA, Castillo-Avila RG, Legorreta-Ramírez BG, López-Narváez ML, Arcila-Novelo R, González-Castro TB. Hypertonic Dextrose Prolotherapy, an Alternative to Intra-Articular Injections With Hyaluronic Acid in the Treatment of Knee Osteoarthritis: Systematic Review and Meta-analysis. Am J Phys Med Rehabil. 2022;101(9):816-825.
39. Wang J, Liang J, Yao J, Song HX, Yang XT, Wu FC, Ye Y, Li JH, Wu T. Meta-analysis of clinical trials focusing on hypertonic dextrose prolotherapy (HDP) for knee osteoarthritis. Aging Clin Exp Res. 202234(4):715-724
40. Johnston E, Kou Y, Junge J, Chen L, Kochan A, Johnston M, Rabago D. Hypertonic Dextrose Stimulates Chondrogenic Cells to Deposit Collagen and Proliferate. Cartilage. 2021;13(2_suppl):213S-224S.
41. Waluyo Y, Budu, Bukhari A, Adnan E, Haryadi RD, Idris I, Hamid F, Usman A, Johan MP, Zainuddin AA. Changes in levels of cartilage oligomeric proteinase and urinary C-terminal telopeptide of type II collagen in subjects with knee osteoarthritis after dextrose prolotherapy: A randomized controlled trial. J Rehabil Med. 2021;53(5):jrm00196.
42. Topol GA, Pestalardo IG, Reeves KD, Elias F, Steinmetz NJ, Cheng AL, Rabago D. Dextrose Prolotherapy for Symptomatic Grade IV Knee Osteoarthritis: A Pilot Study of Early and Longer-Term Analgesia and Pain-Specific Cytokine Concentrations. Clin Pract. 2022;12(6):926-938.
43. Pan PJ, Wang JC, Tsai CC, Kuo HC. Identification of early response to hypertonic dextrose prolotherapy markers in knee osteoarthritis patients by an inflammation-related cytokine array. J Chin Med Assoc. 2022;85(4):525-531
44. Wu TJ, Lin CY, Tsai CH, Huang YL, Tang CH. Glucose suppresses IL-1β-induced MMP-1 expression through the FAK, MEK, ERK, and AP-1 signaling pathways. Environ Toxicol. 2018;33(10):1061-1068.
45. Topol GA, Pestalardo IG, Reeves KD, Elias F, Steinmetz NJ, Cheng AL, Rabago D. Dextrose Prolotherapy for Symptomatic Grade IV Knee Osteoarthritis: A Pilot Study of Early and Longer-Term Analgesia and Pain-Specific Cytokine Concentrations. Clin Pract. 2022;12(6):926-938.
46. Cho JH. Updates on the treatment of adhesive capsulitis with hydraulic distension. Yeungnam Univ J Med. 2021;38(1):19-26
2. Leafblad N, Mizels J, Tashjian R, Chalmers P. Adhesive Capsulitis. Phys Med Rehabil Clin N Am. 2023;34(2):453-468
3. Redler LH, Dennis ER. Treatment of Adhesive Capsulitis of the Shoulder. J Am Acad Orthop Surg. 2019;27(12):e544-e554.
4. Inui H, Hashimoto T, Nobuhara K. External rotation during elevation of the arm. Acta Orthop. 2009;80(4):451-5
5. Ramirez J. Adhesive Capsulitis: Diagnosis and Management. Am Fam Physician. 2019; 99(5):297-300
6. Struyf F, Meeus M. Current evidence on physical therapy in patients with adhesive capsulitis: what are we missing? Clin Rheumatol. 2014;33(5):593-600
7. Horst R, Maicki T, Trąbka R, Albrecht S, Schmidt K, Mętel S, von Piekartz H. Activity- vs. structural-oriented treatment approach for frozen shoulder: a randomized controlled trial. Clin Rehabil. 2017;31(5):686-695
8. Chan HBY, Pua PY, How CH. Physical therapy in the management of frozen shoulder. Singapore Med J. 2017;58(12):685-689
9. Page MJ, Green S, Kramer S, Johnston RV, McBain B, Chau M, Buchbinder R. Manual therapy and exercise for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev. 2014;(8):CD011275
10. Davies C, The Frozen Shoulder Workbook, New Harbinger Publications 2006
11. Sung JH, Lee JM, Kim JH. The Effectiveness of Ultrasound Deep Heat Therapy for Adhesive Capsulitis: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022;19(3):1859
12. Weiss JJ, Ting YM. Arthrography-assisted intra-articular injection of steroids in treatment of adhesive capsulitis. Arch Phys Med Rehabil. 1978;59(6):285-7
13. Millar NL, Meakins A, Struyf F, Willmore E, Campbell AL, Kirwan PD, Akbar M, Moore L, Ronquillo JC, Murrell GAC, Rodeo SA. Frozen shoulder. Nat Rev Dis Primers. 2022;8(1):59
14. Sun Y, Lu S, Zhang P, Wang Z, Chen J. Steroid Injection Versus Physiotherapy for Patients With Adhesive Capsulitis of the Shoulder: A PRIMSA Systematic Review and Meta-Analysis of Randomized Controlled Trials. Medicine (Baltimore). 2016;95(20):e3469
15. Tafti D, Schultz D. Shoulder Joint Injection. 2023 May 22. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. PMID: 32644744.
16. Lin CY, Huang SC, Tzou SJ, Yin CH, Chen JS, Chen YS, Chang ST. A Positive Correlation between Steroid Injections and Cuff Tendon Tears: A Cohort Study Using a Clinical Database. Int J Environ Res Public Health. 2022;19(8):4520
17. McAlindon TE, LaValley MP, Harvey WF, Price LL, Driban JB, Zhang M, Ward RJ. Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. JAMA. 2017;317(19):1967-1975
18. Lemos SE. Editorial Commentary: Periarticular and Intra-Articular Injections May Do the Right Thing for Patients' Pain but May Be the Wrong Thing for Their Articular Cartilage: Be Careful. Arthroscopy. 2022; 38(6):1996-1998
19. Pereira H, Sousa DA, Cunha A, Andrade R, Espregueira-Mendes J, Oliveira JM, Reis RL. Hyaluronic Acid. Adv Exp Med Biol. 2018; 1059:137-153
20. Rossi LA, Piuzzi NS, Shapiro SA. Glenohumeral Osteoarthritis: The Role for Orthobiologic Therapies: Platelet-Rich Plasma and Cell Therapies. JBJS Rev. 2020; 8(2):e0075
21. Centeno CJ, Berger DR, Money BT, Dodson E, Urbanek CW, Steinmetz NJ. Percutaneous autologous bone marrow concentrate for knee osteoarthritis: patient-reported outcomes and progenitor cell content. Int Orthop. 2022;46(10):2219-2228
22. Centeno CJ, Al-Sayegh H, Bashir J, Goodyear S, Freeman MD. A prospective multi-site registry study of a specific protocol of autologous bone marrow concentrate for the treatment of shoulder rotator cuff tears and osteoarthritis. J Pain Res. 2015;8:269-76
23. Condron NB, Kester BS, Tokish JM, Zumstein MA, Gobezie R, Scheibel M, Cole BJ. Nonoperative and Operative Soft-Tissue, Cartilage, and Bony Regeneration and Orthopaedic Biologics of the Shoulder: An Orthoregeneration Network (ON) Foundation Review. Arthroscopy. 2021;37(10):3200-3218
24. Centeno C, Fausel Z, Stemper I, Azuike U, Dodson E. A Randomized Controlled Trial of the Treatment of Rotator Cuff Tears with Bone Marrow Concentrate and Platelet Products Compared to Exercise Therapy: A Midterm Analysis. Stem Cells Int. 2020;2020:5962354
25. Ünlü B, Çalış FA, Karapolat H, Üzdü A, Tanıgör G, Kirazlı Y. Efficacy of platelet-rich plasma injections in patients with adhesive capsulitis of the shoulder. Int Orthop. 2021;45(1):181-190
26. Mao B, Peng R, Zhang Z, Zhang K, Li J, Fu W. The Effect of Intra-articular Injection of Hyaluronic Acid in Frozen Shoulder: a Systematic Review and Meta-analysis of Randomized Controlled Trials. J Orthop Surg Res. 2022;17(1):128
27. Zhao AT, Caballero CJ, Nguyen LT, Vienne HC, Lee C, Kaye AD. A Comprehensive Update of Prolotherapy in the Management of Osteoarthritis of the Knee. Orthop Rev (Pavia). 2022;14(4):33921.
28. Martínez-Pizarro S. Prolotherapy with dextrose to reduce pain in osteoarthritis of the knee. Reumatol Clin (Engl Ed). 2022; 18(4):251-252.
29. Rabago D, Ralston B, Zaharoff A. Prolotherapy: An Evidence-Based Adjunctive Therapy for Knee Osteoarthritis. Am Fam Physician. 2021;103(7):395.
30. Cho JH. Updates on the treatment of adhesive capsulitis with hydraulic distension. Yeungnam Univ J Med. 2021;38(1):19-26
31. Chung SG, Lee KJ, Kim HC, Seo KS, Lee YT. Intra-articular pressure profiles of painful stiff shoulders compared with those of other conditions. PM R. 2009;1(4):297-307
32. Lee JH, Kim SB, Lee KW, Lee SJ, Lee JU. Effect of Hypertonic Saline in Intra-Articular Hydraulic Distension for Adhesive Capsulitis. PM R. 2015;7(7):721-726
33. Lee JH, Kim SB, Lee KW, Lee SJ, Lee JU. Effect of Hypertonic Saline in Intra-Articular Hydraulic Distension for Adhesive Capsulitis. PM R. 2015;7(7):721-726
34. Zhao AT, Caballero CJ, Nguyen LT, Vienne HC, Lee C, Kaye AD. A Comprehensive Update of Prolotherapy in the Management of Osteoarthritis of the Knee. Orthop Rev (Pavia). 2022;14(4):33921.
35. Martínez-Pizarro S. Prolotherapy with dextrose to reduce pain in osteoarthritis of the knee. Reumatol Clin (Engl Ed). 2022; 18(4):251-252.
36. Rabago D, Ralston B, Zaharoff A. Prolotherapy: An Evidence-Based Adjunctive Therapy for Knee Osteoarthritis. Am Fam Physician. 2021;103(7):395.
37. Wee TC, Neo EJR, Tan YL. Dextrose prolotherapy in knee osteoarthritis: A systematic review and meta-analysis. J Clin Orthop Trauma. 2021;19:108-117.
38. Arias-Vázquez PI, Tovilla-Zárate CA, Castillo-Avila RG, Legorreta-Ramírez BG, López-Narváez ML, Arcila-Novelo R, González-Castro TB. Hypertonic Dextrose Prolotherapy, an Alternative to Intra-Articular Injections With Hyaluronic Acid in the Treatment of Knee Osteoarthritis: Systematic Review and Meta-analysis. Am J Phys Med Rehabil. 2022;101(9):816-825.
39. Wang J, Liang J, Yao J, Song HX, Yang XT, Wu FC, Ye Y, Li JH, Wu T. Meta-analysis of clinical trials focusing on hypertonic dextrose prolotherapy (HDP) for knee osteoarthritis. Aging Clin Exp Res. 202234(4):715-724
40. Johnston E, Kou Y, Junge J, Chen L, Kochan A, Johnston M, Rabago D. Hypertonic Dextrose Stimulates Chondrogenic Cells to Deposit Collagen and Proliferate. Cartilage. 2021;13(2_suppl):213S-224S.
41. Waluyo Y, Budu, Bukhari A, Adnan E, Haryadi RD, Idris I, Hamid F, Usman A, Johan MP, Zainuddin AA. Changes in levels of cartilage oligomeric proteinase and urinary C-terminal telopeptide of type II collagen in subjects with knee osteoarthritis after dextrose prolotherapy: A randomized controlled trial. J Rehabil Med. 2021;53(5):jrm00196.
42. Topol GA, Pestalardo IG, Reeves KD, Elias F, Steinmetz NJ, Cheng AL, Rabago D. Dextrose Prolotherapy for Symptomatic Grade IV Knee Osteoarthritis: A Pilot Study of Early and Longer-Term Analgesia and Pain-Specific Cytokine Concentrations. Clin Pract. 2022;12(6):926-938.
43. Pan PJ, Wang JC, Tsai CC, Kuo HC. Identification of early response to hypertonic dextrose prolotherapy markers in knee osteoarthritis patients by an inflammation-related cytokine array. J Chin Med Assoc. 2022;85(4):525-531
44. Wu TJ, Lin CY, Tsai CH, Huang YL, Tang CH. Glucose suppresses IL-1β-induced MMP-1 expression through the FAK, MEK, ERK, and AP-1 signaling pathways. Environ Toxicol. 2018;33(10):1061-1068.
45. Topol GA, Pestalardo IG, Reeves KD, Elias F, Steinmetz NJ, Cheng AL, Rabago D. Dextrose Prolotherapy for Symptomatic Grade IV Knee Osteoarthritis: A Pilot Study of Early and Longer-Term Analgesia and Pain-Specific Cytokine Concentrations. Clin Pract. 2022;12(6):926-938.
46. Cho JH. Updates on the treatment of adhesive capsulitis with hydraulic distension. Yeungnam Univ J Med. 2021;38(1):19-26