A breakthrough in musculoskeletal interventional radiology is redefining the landscape of frozen shoulder and shoulder-pain management. Dr.Gaurav Kant Sharma, a leading musculoskeletal and sports radiologist and director/founder of the Jaipur Institute of Pain and Sports Injuries (JIPSI), has introduced the Gaurav Botchu Technique—a novel ultrasound-guided approach to rotator-interval (RI) injection. This advanced, patient-centred method overcomes the limitations of traditional lateral-approach injections and offers a safer, more effective alternative for treating adhesive capsulitis.
Anatomical Advantage
The rotator interval is a complex triangular space in the shoulder that plays a critical role in joint stability. It contains structures such as the long head of the biceps tendon (LHB), coracohumeral ligament (CHL), and superior glenohumeral ligament (SGHL). Injecting into this narrow zone, especially via the traditional lateral-to-medial approach, is technically challenging and poses a high risk of inadvertently injuring the biceps or supraspinatus tendon. The GauravBotchu Technique, developed in collaboration with international expert Dr. Rajesh Botchu (ROH Birmingham), introduces a medial-to-lateral needle approach. This increases the target zone from approximately 0.5 mm to 2 mm and greatly enhances procedural precision, patient safety, and clinical outcomes.
Procedure & Clinical Success
In the traditional method, the lateral-to-medial trajectory risks injuring the supraspinatus tendon or misplacing the needle within the LHB, potentially causing complications such as biceps rupture. Dr. Sharma's new technique avoids the supraspinatus entirely and provides a wider target zone, enabling even early-career practitioners to perform the procedure confidently and without risk.
Using high-frequency (15 MHz) ultrasound, the patient lies supine with the arm externally rotated. The needle is guided in real time between the CHL and LHB. Once it reaches the correct plane, a free-flow injection confirms accurate placement.This approach is particularly effective for hydrodilatation to treat frozen shoulder (adhesive capsulitis), showing excellent clinical success with rapid and near-complete recovery.
"Precision, safety, and patient comfort were the guiding principles behind the development of this technique," says Dr. Sharma. "At JIPSI, we constantly innovate to bring the best of global science to India in a patient-friendly, minimallyinvasive manner."
Innovation at JIPSI
Established in 2021, JIPSI is at the forefront of regenerative therapy and ultrasound-guided interventions, offering cutting-edge treatments such as Platelet Rich Plasma (PRP), Bone Marrow Aspirate Concentrate (BMAC), stem-cell injections, and other image-guided, minimally invasive procedures for various musculoskeletal conditions.
Dr. Sharma, alongside Dr. Prableen Kaur and their skilled team, ensures comprehensive patient care—from diagnosis to rehabilitation—under one roof. His contributions to sports radiology and sports medicine, through novel technique development, have revolutionised return-to-play (RTP) timelines for athletes and provided relief for individuals with chronic musculoskeletal conditions.
Global Recognition & Training
The Gaurav Botchu Technique was published in the Journal of Ultrasonography (Poland) and recognized as a notable advancement in image-guided musculoskeletal interventions. It is now included in cadaveric workshops and international conference sessions to enhance procedural skills among young radiologists and pain physicians.
"Training clinicians to adopt safer and more effective practices is as important as innovating new techniques," adds Dr. Sharma. "We aim to integrate the Gaurav Botchu Technique into teaching modules for musculoskeletal interventions."
JIPSI's minimally invasive Vision
JIPSI combines innovation, precision, and compassion through minimally invasive procedures such as:
Stem-cell injections for cartilage defects and stress fractures
Thread-release for severe carpal-tunnel syndrome
Hydrodissections for complex nerve entrapments
BMAC and adipose-derived stem-cell therapy for osteoarthritis
The GIBPS technique: sequential corticosteroid injections into the glenohumeral joint and subacromial-subdeltoid bursa in a single session
Orthobiologics treatment for other degenerative tendon/ligament injuries
Looking Ahead
With thousands of successful procedures and multiple innovations to his name, Dr. Gaurav Kant Sharma continues to set new standards in musculoskeletal and sports radiology. His work is transforming treatment paradigms in India and shaping global standards in image-guided musculoskeletal interventions.