Effects of Intra-Articular Triamcinolone Injection on Adhesive Capsulitis after Breast Cancer Surgery

TL;DR

This study shows that triamcinolone injections help treat shoulder stiffness after breast cancer surgery, but are less effective than for non-cancer-related cases.

Contribution

Demonstrates the effectiveness and safety of triamcinolone for post-breast cancer adhesive capsulitis, highlighting reduced efficacy compared to idiopathic cases.

Findings

Triamcinolone injections improved shoulder function and pain in both groups, but less so in the breast cancer group.

No adverse events were observed in either group receiving the injections.

Improvements in pain and range of motion were significantly lower in the breast cancer surgery group at 3 and 6 months.

Abstract

Purpose: To investigate the effects of intra-articular glenohumeral joint triamcinolone injection in treating secondary adhesive capsulitis after breast cancer surgery. Methods: This study prospectively enrolled 37 participants, including 22 in the breast cancer surgery group and 15 in the idiopathic group. All participants received intra-articular glenohumeral joint triamcinolone injection in the affected shoulder joint. The clinical outcomes included the Shoulder Pain and Disability Index (SPADI), passive range of motion (PROM), and pain intensity on the Numeric Rating Scale (NRS), which were evaluated before the intervention and 1, 3, and 6 months after. The primary outcome of this study was the mean difference in the total SPADI from baseline to 6 months after the intervention. Results: The mean differences in the total SPADI scores from baseline to 6 months after the intervention were 36.2 ± 16.4 and 47.9 ± 15.2 in the breast cancer surgery group and the idiopathic group, respectively. There was no significant difference between the two groups (p = 0.1495). However, the improvements in the SPADI pain subscale at the 3- and 6-month follow-up visits (−31.2 vs. −48.8, p = 0.042; −34.1 vs. −50.7, p = 0.0006) and the PROM of abduction at the 3-month follow-up (52.4 vs. 70.3, p = 0.0072) were inferior in the breast cancer surgery group compared to the idiopathic group. There were no adverse events in either group. Conclusion: Intra-articular triamcinolone injection is an effective and safe treatment option for adhesive capsulitis after breast cancer surgery; however, it has less effect than for idiopathic adhesive capsulitis.

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