Subacromial or Systemic Steroid Injection for Rotator Cuff Disease?

2009 ◽  
Vol 19 (6) ◽  
pp. 507-508 ◽  
Author(s):  
Robert McCormack
Keyword(s):  
Rotator Cuff ◽  
Steroid Injection ◽  
Systemic Steroid ◽  
Rotator Cuff Disease

scholarly journals Subacromial ultrasound guided or systemic steroid injection for rotator cuff disease: randomised double blind study

BMJ ◽  
2009 ◽  
Vol 338 (jan23 1) ◽  
pp. a3112-a3112 ◽  
Author(s):  
O. M Ekeberg ◽  
E. Bautz-Holter ◽  
E. K Tveita ◽  
N. G Juel ◽  
S. Kvalheim ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Steroid Injection ◽  
Blind Study ◽  
Systemic Steroid ◽  
Double Blind Study ◽  
Rotator Cuff Disease ◽  
Ultrasound Guided ◽  
Double Blind

Allogenic Pure Platelet-Rich Plasma Therapy for Rotator Cuff Disease: A Bench and Bed Study

2018 ◽  
Vol 46 (13) ◽  
pp. 3142-3154 ◽  
Author(s):  
Chris Hyunchul Jo ◽  
Seung Yeon Lee ◽  
Kang Sup Yoon ◽  
Sohee Oh ◽  
Sue Shin
Keyword(s):  
Clinical Study ◽  
Rotator Cuff ◽  
Adverse Events ◽  
Steroid Injection ◽  
Platelet Rich Plasma ◽  
In Vitro Study ◽  
Shoulder Function ◽  
Vitro Study ◽  
Rotator Cuff Disease

Background: Although platelet-rich plasma (PRP) is a popular option for rotator cuff disease, the underlying mechanism of PRP and its clinical indications are unclear. Further, some kinds of PRP might be detrimental to patients. Allogenic PRP prepared through a standardized process and fully characterized could eliminate variations in PRP as well as uncertainties regarding its use in each patient, which could provide clues about its mechanism of action and indications for its use. Purpose: To assess the effects of pure PRP on tenocytes with or without inflammation in an in vitro study and to evaluate the safety and efficacy of a fully characterized pure PRP injection in patients with rotator cuff disease in a clinical study. Study Design: Controlled laboratory study and cohort study; Level of evidence, 3. Methods: For the in vitro study, tenocytes were enzymatically isolated and cultured from patients with rotator cuff tear and treated with or without interleukin 1β (IL-1β) and PRP. Gene expression and protein synthesis of pro- and anti-inflammatory cytokines, enzymes and their inhibitors, matrix synthesis, and cell viability were evaluated. For the clinical study, a total of 17 patients with rotator cuff disease received ultrasonography-guided subacromial PRP injection and were followed for 6 months. Pain, range of motion, muscle strength, shoulder function, and overall satisfaction in patients were compared with the results in a propensity score–matched control group who received corticosteroid (triamcinolone acetonide 40 mg). Results: PRP induced inflammation in the absence of inflammation and ameliorated inflammation in IL-1β-induced tendinopathic conditions by regulation of cytokines such as IL-1β, cyclooxygenase 2, microsomal prostaglandin E synthase 1, vasoactive intestinal peptide, and downstream matrix metalloproteinases. No general or local adverse events were noted with regard to allogenic PRP injection. Whereas steroid injection showed earlier improvement in some kinds of pain and functional scores, PRP generally showed comparable effects with steroid injection in all clinical outcomes at 6 months. Conclusion: This study showed that allogenic pure PRP had pleiotropic effects on tenocytes depending on inflammation and that it did not cause adverse events but rather decreased pain and improved shoulder function to a degree comparable with steroid injection in patients with rotator cuff disease. Clinical Relevance: Allogenic PRP could be a treatment option for rotator cuff disease.

Sleep Impairment

2009 ◽  
Vol 14 (3) ◽  
pp. 7-10
Author(s):  
Craig Uejo ◽  
Stephen Demeter
Keyword(s):  
Rotator Cuff ◽  
Distal Clavicle ◽  
Rotator Cuff Disease ◽  
Degenerative Arthritis ◽  
Sixth Edition ◽  
Cuff Tear ◽  
Shoulder Region ◽  
Illness Causation ◽  
Traumatic Rotator Cuff Tear ◽  
Distal Clavicle Resection

Abstract In the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, distal clavicle resection (resection arthroplasty of the acromioclavicular joint [ACJ]) results in ratable impairment, but only a single diagnosis within a region may be rated. Therefore, if another impairing condition is present in the shoulder region (eg, impingement syndrome or rotator cuff disease) only that resulting in the greatest causally related impairment is rated. In the setting of an occupational or other compensable injury or illness, causation of the impairment often is a key issue because, typically, only impairment that is causally related to the injury can be rated. For example, assume that a lifting injury at work caused a tear in a rotator cuff tendon that was already attenuated by repetitive impingement on inferiorly projecting spurs from longstanding degenerative arthritis of the ACJ. If surgery was performed for a traumatic rotator cuff tear and the distal clavicle also was resected due to preexisting ACJ arthritis, the latter surgery is not considered to be related to the injury. In other words, because the ACJ arthritis was neither caused nor worsened by the injury, this condition is not rated. The distal clavicular resection may have been warranted to diminish pain due to ACJ arthritis and/or eliminate the distal clavicle as a source of impingement.

scholarly journals Prevalence of Prescription Opioids for Nonoperative Treatment of Rotator Cuff Disease Is High

2021 ◽  
Vol 3 (2) ◽  
pp. e373-e379
Author(s):  
Jacob Gorbaty ◽  
Susan M. Odum ◽  
Meghan K. Wally ◽  
Rachel B. Seymour ◽  
Nady Hamid ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Nonoperative Treatment ◽  
Prescription Opioids ◽  
Rotator Cuff Disease
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