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Accuracy of the Glenohumeral Injection Using the Superior Approach

A Cadaveric Study of Injection Accuracy

Kim, Joon-Sung, MD, PhD; Yun, Jong Soo, MD; Kim, Jae Min, MD; Ko, Young Jin, MD, PhD; Rhee, Won Ihl, MD, PhD; Ha, Nan Kyung, MD, PhD; Kim, Min-Wook, MD, PhD

American Journal of Physical Medicine & Rehabilitation: September 2010 - Volume 89 - Issue 9 - p 755-758
doi: 10.1097/PHM.0b013e3181e7201a
Original Research Article: Injections
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Kim J-S, Yun JS, Kim JM, Ko YJ, Rhee WI, Ha NK, Kim M-W: Accuracy of the glenohumeral injection using the superior approach: a cadaveric study of injection accuracy.

Objective: The glenohumeral joint can be accessed by anterior, posterior, or superior approach. Blind shoulder injections using anterior or posterior approach have been often inaccurate and infiltrated untargeted structures. The aim of this study was to investigate the success rate of injections in the glenohumeral joint using the superior approach.

Design: Nineteen shoulders from 12 adult cadavers were anatomically dissected after a dye injection had been performed, with cadavers in the supine position. A clinician rated injection confidence scores. The dissectors rated injection accuracy scores and investigated untargeted structures penetrated.

Results: The clinician's confidence scores were the highest in 18 of 19 shoulders. Superior glenohumeral injections were successful in 18 of 19 (94.7%) shoulders; however, in 3 of these 18 shoulders, the long heads of biceps tendons were penetrated.

Conclusions: The glenohumeral joint injection using the superior approach is accurate and clinically useful, but caution for the likelihood of penetrating the long head of biceps tendon should be considered.

From the Department of Rehabilitation Medicine (J-SK), College of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, South Korea; Department of Rehabilitation Medicine (JSY), Daejeon St. Mary's Hospital, Daejeon, South Korea; Department of Rehabilitation Medicine (JMK, M-WK), Incheon St. Mary's Hospital, Incheon, South Korea; Department of Rehabilitation Medicine (YJK), Seoul St. Mary's Hospital, Seoul, South Korea; Department of Rehabilitation Medicine (WIR), Yeouido St. Mary's Hospital, Seoul, South Korea; Department of Orthopedic Medicine (NKH), College of Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, South Korea; and Institute of Catholic Integrative Medicine (M-WK), Incheon St. Mary's Hospital, Incheon, South Korea.

All correspondence and requests for reprints should be addressed to Min-Wook Kim, MD, PhD, Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital, 665 Bupyong-6-dong, Bupyong-ku, Incheon 403-720, South Korea.

This work was supported by Catholic Institute for Applied Anatomy, Department of Anatomy, College of Medicine, Catholic University of Korea, Seoul, Korea. Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2010 Lippincott Williams & Wilkins, Inc.