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Related Experiment Video

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A Novel Ultrasound-Guided Injection Strategy for Rapid Functional Recovery in Frozen Shoulder: A Multicenter

Dan Zhu1,2, Yunxia Ou3, Yuping Li2

  • 1Department of Neurosurgery, Chongqing Medical University Affiliated Second Hospital, Chongqing, China.

The American Journal of Sports Medicine
|March 18, 2026
PubMed
Summary
This summary is machine-generated.

Ultrasound-guided tendon surface (UGTS) injection offers faster frozen shoulder recovery than manipulation or blind injections. This noninvasive approach provides rapid relief and improved shoulder function within weeks without safety concerns.

Keywords:
articular injectionblind tender point injectionfrozen shoulderhome exercisemanipulation under local anesthesiaultrasound-guided tendon surface injection

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Area of Science:

  • Orthopedics
  • Musculoskeletal Medicine
  • Regenerative Medicine

Background:

  • Current frozen shoulder (FS) treatments face a dilemma: corticosteroids offer medium-term benefits but lack short-term efficacy, while manipulative treatments risk invasiveness.
  • Existing therapies highlight the need for noninvasive approaches that provide prompt therapeutic effects for rapid recovery in frozen shoulder patients.
  • Clinical trial registration: ChiCTR1900025874.

Purpose of the Study:

  • To compare the efficacy and safety of a novel ultrasound-guided tendon surface (UGTS) injection against manipulation under local anesthesia (MULA) and blind tender point (BTP) injection.
  • All treatment groups were combined with intra-articular injection and home exercise protocols.
  • Evaluate short-term and long-term outcomes for frozen shoulder patients receiving different injection and manipulation techniques.

Main Methods:

  • A multicenter randomized controlled trial (RCT) involving 139 patients with frozen shoulder (FS) was conducted between 2019 and 2022.
  • Patients were randomized into three groups: ultrasound-guided tendon surface (UGTS) injection, manipulation under local anesthesia (MULA), and blind tender point (BTP) injection.
  • The primary outcome was 4-week shoulder function (Beijing Friendship Hospital Scale), with secondary outcomes including pain (VAS), range of motion (ROM), and remission rates.

Main Results:

  • The UGTS group demonstrated significantly faster improvement in shoulder function (BFHS scores) and pain relief (VAS) at 1 week compared to MULA and BTP groups.
  • UGTS achieved higher complete remission rates at 1 month (59.2%) and 3 months (79.6%) versus BTP and MULA (P < .05), with rates converging by 24 months.
  • No significant impact on articular cartilage thickness was observed, and no rotator cuff injuries were attributed to UGTS or exercises.

Conclusions:

  • Ultrasound-guided tendon surface (UGTS) injection, when combined with intra-articular injection and exercise, promotes faster recovery in frozen shoulder patients.
  • UGTS represents an effective, noninvasive first-line option for rapid relief in frozen shoulder, demonstrating significant short-term functional and pain improvements.
  • The procedure showed no safety concerns, including no adverse effects on rotator cuff integrity or articular cartilage.