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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Nov 18, 2025; 16(11): 111903
Published online Nov 18, 2025. doi: 10.5312/wjo.v16.i11.111903
Published online Nov 18, 2025. doi: 10.5312/wjo.v16.i11.111903
Improving accuracy for intra-articular injections for capsulitis of the shoulder by changing the injection technique
Jan M A Mens, Department of Huisartsgeneeskunde, Erasmus University Rotterdam, Rotterdam 3015 GD, Zuid-Holland, Netherlands
Ronald T M Van Kalmthout, MSK-Clinic Leiden, VAOG, Leiden 2332 AA, Zuid-Holland, Netherlands
Author contributions: Mens JMA was responsible for the statistical analysis, the raw writing of the manuscript and the correspondence; Van Kalmthout RTM was responsible for the final version of the manuscript; all authors contributed to the formulating of the hypothesis and the collection of the data.
Institutional review board statement: The research Ethics Committee of Erasmus University Rotterdam declared that, since the study was retrospective, no permission was needed.
Informed consent statement: The research Ethics Committee of Erasmus University Rotterdam decided that no written consent was required, because it was a retrospective study and the data were anonymized.
Conflict-of-interest statement: Both authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Data are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jan M A Mens, Senior Researcher, Department of Huisartsgeneeskunde, Erasmus University Rotterdam, Dr. Molewaterplein 40, Rotterdam 3015 GD, Zuid-Holland, Netherlands. info@janmens.nl
Received: July 14, 2025
Revised: September 22, 2025
Accepted: October 23, 2025
Published online: November 18, 2025
Processing time: 125 Days and 12.5 Hours
Revised: September 22, 2025
Accepted: October 23, 2025
Published online: November 18, 2025
Processing time: 125 Days and 12.5 Hours
Core Tip
Core Tip: Some of the fluid injected with the intention of injecting into the shoulder joint appears to end up next to the joint. This is often attributed to leakage. It appears that in a part of the injections, the fluid doesn't leak out of the joint, but is deposited next to it if part of the needle opening is located outside the capsule. A different injection technique appears to have significantly reduced this risk. Based on this idea, a different injection technique was chosen: The Delaware method. This significantly increases the chance of accurate injection compared to the traditional method.