Clinical outcomes (Accuracy and Validity) of arthroscopic intra articular injection to shoulder joint through anterosuperior portal

Abstract

Intra-articular shoulder injections are an important part of orthopedic practices for both therapeutic and diagnostic purposes and provide therapeutic benefit and diagnostic information. Different approaches such as anterior, posterior and superior approach have been proposed. In this study we aim to evaluate the accuracy of intra-articular injection of shoulder joint through antero-superior portal and evaluate it with arthroscopic study. Methods: In this analytical cross-sectional study, 50 patients with different shoulder complaints undergoing shoulder arthroscopy were included. Needle insertion with anterosuperior portal was performed by an orthopedic surgeon under general anesthesia with patients placed in the beach chair position with the arm in adduction and internal rotation. Standard landmarks were used to define the injection site. After needle placement, with standard arthroscopic portal, the scope was inserted in the joint and needle place in the joint was evaluated. Results: Patients were 38 (76%) male and 12 (24%) female with mean age of 45.53±14.40 years. Patients had shoulder instability in 21 cases (42%), rotator cuff tear in 19 cases (38%) and adhesive capsulitis in 10 cases (20%). In 30 cases (60%) needle was placed intra-articular and in 20 cases (40%) extra-articular. Successful intra-articular injections were all from rotator interval, while unsuccessful cases were from subscapularis or supraspinatus. There was no significant difference in the accuracy regarding the diagnosis before surgery or body mass index.