The purpose of this study is to evaluate conservative pain relief measures for patients suffering from glenohumeral arthritis or rotator cuff arthropathy. Conservative management of osteoarthritis is often first line treatment, and while a corticosteroid injection is frequently used, suprascapular nerve blocks have not often been described as an analgesic option in this population.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
40
The patient will be in a seated position. Correct patient, laterality, and procedure will be performed during the timeout. Ultrasound guidance will be used to identify the glenohumeral joint. The injection site will then be disinfected with an alcohol wipe. A 21, 22, or 23-gauge needle (depending on provider preference) will be advanced into the glenohumeral joint under direct ultrasound visualization. After entry into the glenohumeral joint, a negative aspiration will be performed. At that time, up to 1 mL of 40mg/mL methylprednisolone acetate will be injected be injected into the joint space.
The patient will be in a seated position. Correct patient, laterality, and procedure will be performed during the timeout. Ultrasound guidance will be used to identify the suprascapular nerve in its path at the suprascapular notch. After disinfection of the injection site with alcohol, anatomic landmarks for SSNB as described by Dangoisse et al. \[10\] will be marked with a marking pen. Ultrasound will be utilized to guide the tip of a 21, 22, or 23 gauge (depending on provider preference) needle to the floor of the suprascapular fossa while avoiding neurovascular structures. At that time, a mixture of up to 10 mL of 0.5% bupivacaine and 20 mg triamcinolone will be slowly injected to fill the fascial contents of the suprascapular fossa under direct ultrasound guidance.
University of Minnesota
Minneapolis, Minnesota, United States
RECRUITINGchange in visual analog scale (VAS) for pain
a validated continuous scale assessment for pain
Time frame: preintervention, 24 hours, 3 days, 1 month, and 3 months postintervention
single assessment numerical evaluation (SANE) of the shoulder
a validated tool providing a numerical score from 0-100 that assess shoulder function as subjectively reported by the subject. A higher score indicates superior shoulder function.
Time frame: preintervention, 24 hours, 3 days, 1 month, and 3 months postintervention
Oxford shoulder score (OSS)
a validated patient-reported outcome measure used to assess shoulder pain and functional disability. Possible scores range from 0-48 with higher scores indicating superior better shoulder function.
Time frame: preintervention, 24 hours, 3 days, 1 month, and 3 months postintervention
American shoulder and elbow surgeons (ASES) score
a validated survey with possible scores from 0-100 that assesses shoulder function as reported by the subject. A higher score indicates superior shoulder function.
Time frame: preintervention, 24 hours, 3 days, 1 month, and 3 months postintervention
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