Joint lavage of the shoulder

The shoulder joint is mobile and complex. Accurate diagnosis of shoulder pain is made difficult by its anatomy and the position of the shoulder connecting the upper extremity to the thorax. Furthermore, because of its structure, the shoulder joint is the most mobile joint of the human body, allowing the four joints that comprise it to effect coordinated motions. Joint lavage has been in use for some years, being strongly indicated for the knee joint, alhough it is being used more and more frequently as a fairly effective treatment for the shoulder and coxofemoral joints. Joint lavage was initially used as treatment for osteoarthritis as a cause of joint pain but it is also used for other mechanical and inflammatory disorders, including septic arthritis, crystal-induced arthritis, rheumatoid arthritis, adhesive capsulitis and others so that patients with gastrointestinal disease can avoid continous intake of analgesics or anti-inflammatory medication. Various mechanisms of action that make joint lavage a highly effective procedure have been studied and proposed. The present article presents a comparative trial between joint lavage and hyaluronic acid visco-supplementation used to treat soft tissue shoulder disorders. The study's objectives were to value the effectiveness and tolerance of joint lavage of the shoulder for soft tissue conditions compared to intraarticular viscosupplementation hyaluronic acid. 30 patients were treated, 24 of whom were women, randomly divided into two groups with 15 patients in each. There were no differences between the groups as far as variables were concerned: pain, mobility, patient's opinion and doctor's opinion and daily life activity, at all the assessment time points, although both groups showed statistically significant improvement at all the assessment time points relative to the baseline (p < 0.0001). None of the patients dropped out and none reported any adverse effects from the treatments. To conclude, both joint lavage and hyaluronic acid viscosupplementation were shown to be useful, both initially and over time (six months), as treatments for soft tissue shoulder disorders. Both treatments showed good patient tolerance.