Retraction Note to: Inflammation and shoulder pain—a perspective on rotator cuff disease, adhesive capsulitis, and osteoarthritis: conservative treatment

IntroductionAtraumatic and degenerative rotator cuff tears are common in individuals over 55 years of age. This condition can have a high impact on social life and is associated with chronic pain, weakness and dysfunction of the upper limb. There is evidence that conservative approaches should be the first treatment option. Conservative treatment usually addresses a variety of therapeutic behaviours without providing scientific arguments for the choice and progression of exercises.ObjectiveTo compare the effects of two different exercise programmes based on the load of the rotator cuff on a population with shoulder pain and rotator cuff tears.Methods and analysisThis is a controlled, randomised, blinded clinical trial. Seventy-eight individuals with shoulder pain and presence of atraumatic and degenerative rotator cuff tear will participate and will be randomly distributed between two groups. The primary outcome will be quality of life (The Western Ontario Rotator Cuff Index), and secondary outcomes will include pain, function (Disabilities of the Arm, Shoulder and Hand), fear avoidance beliefs (Fear Avoidance Beliefs Questionnaire-Brazil), kinesiophobia (Tampa Scale), Pain Catastrophizing Scale, muscle strength of abductors, external and internal rotators of the shoulder, range of motion of arm elevation and patient satisfaction. The treatment will be performed for 12 weeks (2 x/week) acording to the selected group (Rotator Cuff Unloading x Rotator Cuff Loading Exercise Programme).Ethics and disseminationThe study protocol was approved by the Institutional Review Board. The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences.Trial registration numberNCT03962231.

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Subacromial Tenoxicam Injection in the Treatment of Impingement Syndrome

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967114s00199 ◽

2014 ◽

Vol 2 (11_suppl3) ◽

pp. 2325967114S0019

Author(s):

Hakan Çift ◽

Feyza Ünlü Özkan ◽

Ali Şeker ◽

Mehmet İşyar ◽

Erman Ceyhan ◽

...

Keyword(s):

Rotator Cuff ◽

Shoulder Pain ◽

Adhesive Capsulitis ◽

Adhesion Formation ◽

Impingement Syndrome ◽

Therapeutic Effects ◽

Women Patients ◽

Alternative Treatment Option ◽

Vas Scores ◽

The Mean

Objectives: As subacromial bursa injection is widely used for pain relief and functional improvements in patients with periarticular shoulder disorder, we aimed to present our results of subacromial tenoxicam injection in the treatment of impingement syndrome. Methods: Patients presented to the Department of Orthopaedics and Traumatology, Istanbul Medipol University with the primary complaints of shoulder pain from January 2012 to June 2013 were selected. Those who met the following inclusion criteria were finally considered: 1) who had a clinical sign of a painful arc and positive in Hawkins test and/or Neer impingement sign; 2) who had a precise rotator cuff injury including partial cuff tears, or subacromial bursitis detected during ultrasonography or MRI. The exclusion criteria were as follows: 1) who underwent shoulder surgery; 2) who had full thickness rotator cuff rupture; 3) who had hemiplegic shoulder pain; and 4) who displayed any suspected fracture on X-ray or had a recent shoulder trauma; 5) who showed limited active ROM and stiffness due to adhesive capsulitis. Thirty one shoulders out of thirty patients were treated with subacromial tenoxicam injection. Ten of them were left shoulders. Fifteen of the patients were women.. Patients had a mean age of 51.6 (30-73). Patients were evaluated 4 times. Before the first injection, 1 week after the first injection, 2 weeks after the second injection and 3 weeks after the third injection. In every injection 20 mg tenoxicam was performed. Results: In order to relieve the pain; two patients were given only one injection, thirteen patients were given two injections and “3 injections protocol” were done to fifteen patients. The mean pre- and posttreatment VAS scores were 7.9 (between, 7-9) and 2.7 (between, 2-4) points respectively. The average pre and posttreatment DASH scores were 59.41 (between, 45-80) and 14 (between, 8.3-25.8) points respectively. The mean pre and posttreatment range of motion were 106.1 (between, 80-130 and 170i7 (between, 140-180) degrees respectively. Differences between all pre- and post-treatment parameters were statistically significant (p<0.05). Conclusion: Tenoxicam is a cheap NSAID and an analgesic of the oxicam class, is closely related to proxicam, and has a long half-life, which enables it to be administrated once daily. It also readily penetrates the synovial fluid and intraarticular intravenous administration provides superior postoperative analgesic benefits. Tenoxicam also has the ability to prevent adhesion formation. Besides it has no detrimental effect on cartilage structure. It can be safely administrated intraarticularly. Given the positive therapeutic effects of subacromial tenoxicam injection, it can be used as an alternative treatment option.

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Ultrasound-Guided Hydrodilatation With Triamcinolone Acetonide for Adhesive Capsulitis: A Randomized Controlled Trial Comparing the Posterior Glenohumeral Recess and the Rotator Cuff Interval Approaches

Frontiers in Pharmacology ◽

10.3389/fphar.2021.686139 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jia-Chi Wang ◽

Po-Yi Tsai ◽

Po-Cheng Hsu ◽

Jian-Ru Huang ◽

Kevin A. Wang ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Rotator Cuff ◽

Range Of Motion ◽

Triamcinolone Acetonide ◽

Shoulder Pain ◽

Visual Analog Scale ◽

Controlled Trial ◽

Adhesive Capsulitis ◽

Analog Scale ◽

Randomized Controlled

For patients with adhesive capsulitis, hydrodilatation is typically performed using corticosteroids with ultrasound guidance via the posterior glenohumeral recess. Recently, a new intervention technique via the rotator cuff interval has been described. This study aimed to compare the efficacy of hydrodilatation with triamcinolone acetonide via the posterior glenohumeral recess and the rotator cuff interval in patients with adhesive capsulitis. This prospective randomized controlled trial was conducted in a tertiary care center with a follow-up period of 12 weeks. We enrolled 64 patients diagnosed with shoulder adhesive capsulitis. The subjects were randomly assigned to two groups that received hydrodilatation with corticosteroids either through the posterior glenohumeral recess or though the rotator cuff interval. The injection contained 4 ml of triamcinolone acetonide (40 mg) mixed with 4 ml of 2% lidocaine hydrochloride and 12 ml of normal saline. The shoulder pain and disability index, visual analog scale for pain, and range of motion were analyzed before and at 6 and 12 weeks after the treatment. Both groups experienced improvements in the visual analog scale scores, shoulder pain and disability index scores, and range of motion throughout the study period. A significant group-time interaction was observed in terms of the visual analog scale for pain during motion (p = 0.019), favoring hydrodilatation through the rotator cuff interval. Thus, hydrodilatation through the rotator cuff interval might be a better treatment option than that through the posterior glenohumeral recess for patients with adhesive capsulitis, considering its superior effect in alleviating pain during shoulder movement.

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How do people perceive different labels for rotator cuff disease? A content analysis of data collected in a randomised controlled experiment

BMJ Open ◽

10.1136/bmjopen-2021-052092 ◽

2021 ◽

Vol 11 (12) ◽

pp. e052092

Author(s):

Joshua R Zadro ◽

Zoe A Michaleff ◽

Mary O'Keeffe ◽

Giovanni E Ferreira ◽

Romi Haas ◽

...

Keyword(s):

Rotator Cuff ◽

Shoulder Pain ◽

Rotator Cuff Tear ◽

Poor Prognosis ◽

Impingement Syndrome ◽

Subacromial Impingement Syndrome ◽

Subacromial Impingement ◽

Rotator Cuff Disease ◽

Cuff Tear ◽

Randomised Controlled

ObjectivesExplore how people perceive different labels for rotator cuff disease in terms of words or feelings evoked by the label and treatments they feel are needed.SettingWe performed a content analysis of qualitative data collected in a six-arm, online randomised controlled experiment.Participants1308 people with and without shoulder pain read a vignette describing a patient with rotator cuff disease and were randomised to one of six labels: subacromial impingement syndrome, rotator cuff tear, bursitis, rotator-cuff-related shoulder pain, shoulder sprain and episode of shoulder pain.Primary and secondary outcomesParticipants answered two questions (free-text response) about: (1) words or feelings evoked by the label; (2) what treatments they feel are needed. Two researchers iteratively developed coding frameworks to analyse responses.Results1308/1626 (80%) complete responses for each question were analysed. Psychological distress (21%), uncertainty (22%), serious condition (15%) and poor prognosis (9%) were most often expressed by those labelled with subacromial impingement syndrome. For those labelled with a rotator cuff tear, psychological distress (13%), serious condition (9%) and poor prognosis (8%) were relatively common, while minor issue was expressed least often compared with the other labels (5%). Treatment/investigation and surgery were common among those labelled with a rotator cuff tear (11% and 19%, respectively) and subacromial impingement syndrome (9% and 10%) compared with bursitis (7% and 5%).ConclusionsWords or feelings evoked by certain labels for rotator cuff disease and perceived treatment needs may explain why some labels drive management preferences towards surgery and imaging more than others.

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Are degenerative rotator cuff disorders a cause of shoulder pain? Comparison of prevalence of degenerative rotator cuff disease to prevalence of nontraumatic shoulder pain through three systematic and critical reviews

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2016.09.060 ◽

2017 ◽

Vol 26 (5) ◽

pp. 766-773 ◽

Cited By ~ 9

Author(s):

Karl Vincent ◽

Charlotte Leboeuf-Yde ◽

Olivier Gagey

Keyword(s):

Rotator Cuff ◽

Shoulder Pain ◽

Rotator Cuff Disease ◽

Critical Reviews

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Does This Patient With Shoulder Pain Have Rotator Cuff Disease?

JAMA ◽

10.1001/jama.2013.276187 ◽

2013 ◽

Vol 310 (8) ◽

pp. 837 ◽

Cited By ~ 102

Author(s):

Job Hermans ◽

Jolanda J. Luime ◽

Duncan E. Meuffels ◽

Max Reijman ◽

David L. Simel ◽

...

Keyword(s):

Rotator Cuff ◽

Shoulder Pain ◽

Rotator Cuff Disease

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THU0485 THE EFFECT OF PERINEURAL INJECTION THERAPY IN PERIARTHRITIS SHOULDER

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.166 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 480-481

Author(s):

M. H. Abu-Zaid ◽

S. A. A. Tabra ◽

S. Elmorsy

Keyword(s):

Rotator Cuff ◽

Physical Function ◽

Shoulder Pain ◽

Adhesive Capsulitis ◽

Injection Therapy ◽

Perineural Injection ◽

Group I ◽

End Of Treatment ◽

Significant Difference ◽

Group Ii

Background:Primary adhesive capsulitis of the shoulder is a common pathology of the glenohumeral joint characterized by shoulder pain and progressive restriction of the range of motion,its treatment options either medication, local injection, physiotherapy, hydrodistension, manipulation under anesthesia, arthroscopic and open capsular release1.Subcutaneous prolotherapy injections can reduce vascular endothelial growth factor levels and restore effective repair processes so induce apoptosis of proliferating peptidergic noceffectors and neovessels and inhibit TRPV1 receptors resulting to reduction of pain2,3.Objectives:To assess the effectiveness of perineural injection therapy in management of pain and physical function in Primary adhesive capsulitis of the shoulder.Methods:One hundred patients with primary adhesive capsulitis in the freezing stage were selected in this study according to the classification of Hannafin and Chiaia and had restriction of passive motion of greater than 30°in 2 or more planes of movement. Patients with previous corticosteroid injection or previous surgery in the affected shoulder, secondary adhesive capsulitis including inflammatory or infectious arthritis,previous fracture, rotator cuff lesions were excluded from this study.Ptients were randomly devided into two equal groups; Group I received 6 weekly subcutaneous injections of 0.5-1 ml of buffered dextrose 5% in each chronic constriction injury points and tender points at shoulder and along course of suprascapular, supraclavicular, axillary, musculocutanous and radial nerves. Group II received oral NSAIDs and muscle relaxants for 6 weeks. All patients in both groups received the same stretching and exercise therapy during the period of treatment. All procedures were done after informed consent. Assessments were performed at baseline, at the end of the treatment and after three and six months using visual analog scale (VAS) for pain, range of mvement measurements by goniometer, Shoulder Pain and Disability Index (SPADI) & the Western Ontario Rotator Cuff (WORC) Index.Results:Patients in Group I had more rapid relief of pain and better functional improvement compared with group II (p<0.05). There was significant improvement in both groups (p<0.05) after 3 and 6 months with significant difference between the 2 groups indicated that better results in perineural group. Results were summarized in table 1.Baseline GIBaseline GIIAfter end of treatment GIAfter end of treatment GIIAfter 3ms GIAfter 3ms GIIAfter 6ms GIAfter 6ms GIIVAS8.7±0.98.4±1.05.0±1.5*¶5.7±1.1*4.4±1.5*¶5.1±1.6*3.8±1.2*¶4.9±1.3*SPADI80.4±9.878.9±10.741.5±10.2*¶50.4±8.8*35.8±7.5*¶46.6±7.9*32.6±10.2*¶44.5±8.7*WORC28.5±10.626.5±11.560.4±9.8*¶55.9±10.5*67.9±9.7*¶57.3±10.3*71.5±12.3*¶60.1±9.6**significant improvement after treatment¶significant difference between the two studied groupsConclusion:Perineural injection therapy is an effective modality in management of pain and physical function of Primary adhesive capsulitis of the shoulder.References:[1]Franz A, Klose M, Beitzel K. Conservative treatment of frozen shoulder. Unfallchirurg. 2019;122(12):934-940.[2]Lyftogt J. Subcutaneous prolotherapy treatment of refractory knee, shoulder, and lateral elbow pain. Australasian Musculoskeletal Medicine. 2007; 12(2):110-112[3]Abu-Zaid MH, Tabra SA, Elmorsy S. FRI0687 Effect of perineural injection therapy in moderate and severe knee osteoarthritis; a comparative study. Annals of the Rheumatic Diseases 2018;77:862-863.Disclosure of Interests: :None declared

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Comparison of the therapeutic effects of ultrasound-guided platelet-rich plasma injection and dry needling in rotator cuff disease: a randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215512448388 ◽

2012 ◽

Vol 27 (2) ◽

pp. 113-122 ◽

Cited By ~ 130

Author(s):

Dong-wook Rha ◽

Gi-Young Park ◽

Yong-Kyun Kim ◽

Min Tae Kim ◽

Sang Chul Lee

Keyword(s):

Rotator Cuff ◽

Adverse Effects ◽

Shoulder Pain ◽

Platelet Rich Plasma ◽

Global Rating Scale ◽

Controlled Study ◽

Therapeutic Effects ◽

Dry Needling ◽

Rotator Cuff Disease ◽

Plasma Injection

Objective: To compare the effects of platelet-rich plasma injection with those of dry needling on shoulder pain and function in patients with rotator cuff disease. Design: A single-centre, prospective, randomized, double-blinded, controlled study. Setting: University rehabilitation hospital. Participants: Thirty-nine patients with a supraspinatus tendon lesion (tendinosis or a partial tear less than 1.0 cm, but not a complete tear) who met the inclusion criteria recruited between June 2010 and February 2011. Intervention: Two dry needling procedures in the control group and two platelet-rich plasma injections in the experimental group were applied to the affected shoulder at four-week intervals using ultrasound guidance. Measurements: The Shoulder Pain and Disability Index, passive range of motion of the shoulder, a physician global rating scale at the six-month follow-up, adverse effects monitoring and an ultrasound measurement were used as outcome measures. Results: The clinical effect of the platelet-rich plasma injection was superior to the dry needling from six weeks to six months after initial injection ( P < 0.05). At six months the mean Shoulder Pain and Disability Index was 17.7 ± 3.7 in the platelet-rich plasma group versus 29.5 ± 3.8 in the dry needling group ( P < 0.05). No severe adverse effects were observed in either group. Conclusions: Autologous platelet-rich plasma injections lead to a progressive reduction in the pain and disability when compared to dry needling. This benefit is certainly still present at six months after treatment. These findings suggest that treatment with platelet-rich plasma injections is safe and useful for rotator cuff disease.

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Arthroscopic treatment of an unusual distal clavicle ostheochondroma causing rotator cuff impingement: case report and literature review

Orthopedic Reviews ◽

10.4081/or.2020.8683 ◽

2020 ◽

Author(s):

Piermarco Messinese ◽

Valeria Vismara ◽

Giuseppe Sircana ◽

Vincenzo Campana ◽

Fabrizio Mocini ◽

...

Keyword(s):

Case Report ◽

Rotator Cuff ◽

Conservative Treatment ◽

Shoulder Pain ◽

X Rays ◽

Distal Clavicle ◽

Shoulder Impingement ◽

First Case ◽

Common Causes

Chronic shoulder impingement is one of the most common causes of shoulder pain. Intrinsic, extrinsic and secondary factors play a role in this syndrome; however the etiology of the pathology is still under debate. In rare cases, it can be caused by tumors, such as an osteochondroma. In the present study, a 49-year-old patient presented with shoulder pain for 6 months. Initially he underwent conservative treatment, without relief of symptoms. X-rays and MRI were then performed and showed the presence of an exostotic formation on the undersurface of the lateral third of the clavicle. The formation was arthroscopically removed. Histologic examination confirmed the diagnosis of osteochondroma. After surgery, the patient resumed fully activities with no symptoms within 3 months. At 1 year follow up, there are still no clinical or radiological signs of recurrence. This is, to our knowledge, the first case where an arthroscopic approach was used to remove an ostochondroma of the distal third of the clavicle.

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