Evaluation of the Success rate of Shoulder Arthrocentesis & Injection methods by Orthopedic surgery residents With/without landmarks

Introducing a method with greater ease and success for orthopedic assistants to perform arthrocentesis and injection of the shoulder joint

For randomization, 1:1:1:1:1:1 blocks will be used and no more than two people will be placed in any of the groups. The process of randomization will be done by a person outside the research, and the researcher and assistants participating in the research will not be aware of the process. The sample size includes 10 senior residents and 30 patients

A cross-over trial in 2024 in the orthopedic department of Imam Khomeini Hospital of Tehran University of Medical Sciences.

Inclusion criterion for assistants: studying orthopedic residency course at Tehran University of Medical Sciences. Inclusion criteria for patients: those who referred to Imam Khomeini Hospital of Tehran University of Medical Sciences and are candidates for shoulder arthroscopy with clinical examination and imaging evaluations including X-ray, CT or MRI will be included in the study; age between 18 and 70 years; diagnosis requiring arthroscopic shoulder surgery. Exclusion criteria: Existence of anatomical abnormality in pre-surgical imaging; previous arthroscopy with the previous incision remaining

Each assistant will perform a total of three shoulder arthrocentesis interventions on one patient, and the result will be checked with an arthroscope: Intervention 1: Arthrocentesis without drawing (anatomical)landmarks and without traction of the (patient's) hand; Intervention 2: Arthrocentesis with drawing landmarks and without traction of the hand; Intervention 3: Arthrocentesis with drawing landmarks and with traction of the hand

Ease and success of arthrocentesis and shoulder joint injection techniques by residents Orthopedics in two methods with and without landmarks

This study will be conducted as a cross-over trial in 1402 in Imam Khomeini Hospital of Tehran University of Medical Sciences and in the orthopedic department of this hospital. The study design process will be based on CONSORT guidelines. Study participants will perform shoulder arthrocentesis a total of 3 times: 1 time without landmarks, 1 time with landmarks and without traction, and 1 time with landmarks and with traction.The order of interventions in individuals will be determined in a simple random manner. At first, the necessary training regarding the anatomy of the shoulder joint and how to perform shoulder arthrocentesis with and without landmarks and, in the case of landmarks, with and without traction, will be given to the assistants by the orthopedic professor. The procedure will be performed by the "senior" resident of the group. It will be done under the supervision of the relevant teacher. Then 10 participants in the study will be randomly assigned to one of the following 6 groups and a maximum of two people will be placed in each group.Group 1: without landmark - with landmark with traction - with landmark without traction Group 2: without landmark - with landmark without traction - with landmark with traction Group 3: with landmark without traction - without landmark - with landmark with traction Group 4: with landmark without traction - with landmark with traction - without landmark Group 5: with landmark with traction - without landmark - with landmark without traction Group 6: with landmark with traction - with landmark without traction - without landmark For randomization, 1:1:1:1:1:1 blocks will be used and no more than two people will be placed in any of the groups. The process of randomization will be done by a person outside the research, and the researcher and assistants participating in the research will not be aware of the process. This is for Allocation Concealment, so that there is no intervention in terms of allocation of interventions by the research team.

The researchers and the statistical analyst will not be aware of the intervention and the interventions will be defined as A, B, and C by a person outside the research for the researchers and the team of researchers from the assigned order and also the definition of the codes until after the implementation. Research will not be informed. In this way, the study will be done in a double-blind manner