scholarly journals The effects of a single-dose subacromial injection of a nonsteroidal anti-inflammatory drug in geriatric patients with subacromial impingement syndrome: a randomized double-blind study

2021 ◽  
Vol 24 (1) ◽  
pp. 4-8
Author(s):  
Young-Bea Kim ◽  
Woo-Seung Lee ◽  
Jun-Sung Won
Keyword(s):  
Los Angeles ◽  
Rotator Cuff ◽  
Lidocaine Hydrochloride ◽  
Subacromial Impingement Syndrome ◽  
Symptom Improvement ◽  
Double Blind Study ◽  
Subacromial Injection ◽  
Nsaid Group ◽  
Steroid Group ◽  
Anti Inflammatory

Background: As nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids have similar effects, steroids can be avoided to reduce adverse effects. This study aimed to compare the differences in symptom improvement after subacromial injection of steroids or NSAIDs.Methods: Sixty patients with rotator cuff syndrome for at least 3 months were enrolled and divided into steroid and NSAID groups. The steroid group received a mixture of 1 mL of triamcinolone acetonide (40 mg/mL) and 1 mL of lidocaine hydrochloride 2%, while the NSAID group received a mixture of 1 mL of Ketorolac Tromethamine (30 mg/mL) and 1 mL of lidocaine hydrochloride 2%. The patients were assessed before and at 3, 6, and 12 weeks after the procedure. Shoulder scores from visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES), and University of California Los Angeles (UCLA) were used for evaluation.Results: Both groups showed improvements in the clinical outcomes. Overall VAS, ASES, and UCLA scores improved from 6.9, 32.7, and 16.0 before the procedure to 2.0, 1.2, and 1.1; 81.5, 87.6, and 88.5; and 29.7, 31.8, and 32.0 at weeks 3, 6, and 12 weeks after the procedure, respectively. Twenty-six patients (86.7%) in the steroid group and 28 (93.3%) in the NSAID group reported satisfactory treatment outcomes. There were no significant differences in the outcomes between the two groups (p=0.671).Conclusions: Subacromial injection of NSAIDs for rotator cuff tendinitis with shoulder pain had equivalent outcomes with those of steroid injection at the 12-week follow-up.

scholarly journals The effects of steroidal and non-steroidal anti-inflammatory drugs on tracheal wound healing in an experimental rat model

2020 ◽  
Vol 30 (4) ◽  
pp. 646-651
Author(s):  
Elif Duman ◽  
Kenan Can Ceylan ◽  
Deniz Akpınar ◽  
Nur Yücel ◽  
Şaban Ünsal ◽  
...  
Keyword(s):  
Wound Healing ◽  
Rat Model ◽  
Control Group ◽  
Albino Rats ◽  
Nsaid Group ◽  
Steroid Group ◽  
Histological Characteristics ◽  
Experimental Rat Model ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract OBJECTIVES The effect of non-steroidal anti-inflammatory drugs (NSAID), mostly used for postoperative analgesic purposes for wound healing, is still a matter of debate. Our goal was to evaluate the effects of the most widely used NSAID and corticosteroids after surgical operations on tracheal wound healing in an experimental rat model. METHODS Thirty-nine male Wistar albino rats were included in this study. Tracheotomy was performed in 32 rats; then they were divided into 3 groups. After the first day, the animals in group 1 were treated with an NSAID (diclofenac 10 mg/kg/day) (NSAID, n = 12) for 7 days; the animals in group 2 were treated with a corticosteroid (dexamethasone, 2 × 0.1 mg/kg/day) (steroid, n = 10) for 7 days; the animals in group 3 (control, n = 10) were not given any medications. For a fourth group (histological control, n = 7), in order to evaluate normal morphological and histological characteristics, neither surgery nor medication was used. Five rats were eliminated from the study (2 rats in the NSAID group died and 3 rats in the steroid group developed local wound infections). The drop-out rate was 12.8%. Histological characteristics, inflammation, fibrosis, necrosis, neochondrogenesis, neovascularization and epithelization were evaluated in 34 rats. Non-parametric tests were used for statistical analysis. RESULTS Inflammation, vascularization and number of fibroblasts and chondrocytes were significantly higher in the control group than in the histological control group. There was some reduction in all parameters except vascularization in the NSAID group (P > 0.05). When the steroid group was compared to the NSAID group, inflammation (P < 0.05), vascularization and number of chondrocytes (P > 0.05) were more suppressed in the steroid group. The number of fibroblasts increased in the steroid group (P > 0.05). CONCLUSIONS Steroids and NSAID may have negative effects on tracheal wound healing, probably by suppressing inflammation and fibroblast proliferation. NSAID was mostly used postoperatively for analgesic purposes and should be avoided.

Muscle Activity Before and After Subacromial Injection

2021 ◽  
pp. 1-7
Author(s):  
Lucas Ettinger ◽  
Matthew Shaprio ◽  
Andrew Karduna
Keyword(s):  
Rotator Cuff ◽  
Muscle Activation ◽  
Rotator Cuff Tears ◽  
Subacromial Impingement ◽  
Upper Trapezius ◽  
Subacromial Injection ◽  
Shoulder Muscle ◽  
Shoulder Muscles ◽  
Before And After ◽  
Arm Elevation

Context: Shoulder muscle activation in patients with subacromial impingement is highly cited and variable in the literature. Differences between studies could be due to artifacts introduced by normalization practices in the presence of pain. Ultimately, this lack of knowledge pertaining to pathogenesis limits the clinical treatment and restoration of muscular function. Design: A total of 21 patients with stage 2 subacromial impingement and 21 matched controls were recruited for EMG testing of their affected shoulder during an arm elevation task. The patients were tested before and after receiving an injection to their subacromial bursa. Methods: The EMG from 7 shoulder muscles were measured before and after treatment during humeral motion in the scapular plane. Results: Our findings indicate an increase in anterior deltoid, middle deltoid, and upper trapezius activity following the injection; further, this trend extended to the controls. The control subjects had a greater activation of the latissimus dorsi at peak arm elevation when compared with the patient group postinjection. Conclusions: Our results indicate that a reduction in subacromial pain is associated with changes in shoulder muscle recruitment, primarily of the deltoid. This change in deltoid activity may lend evidence to rotator cuff function in patients without rotator cuff tears.

Platelet-Rich Plasma versus Corticosteroid Injections in Rotator Cuff Related Shoulder Pain: A Comparative Study with Up to 18 Months of Follow-Up

2021 ◽  
Author(s):  
Juho Annaniemi ◽  
Jüri Pere ◽  
Salvatore Giordano
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Platelet Rich Plasma ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Subacromial Injection ◽  
Western Ontario Rotator Cuff ◽  
Feasible Alternative ◽  
Cuff Repair

Abstract Purpose: Given the complications involved in corticosteroid (CS) injections, subacromial platelet-rich plasma (PRP) injections may provide a valid alternative to CS in the treatment of rotator cuff related shoulder pain (RCRSP).Methods: We retrospectively reviewed a total of 98 patients affected by RCRSP who were treated with either subacromial injection of PRP or CS. The PRP group received three injections of autologous PRP at two weeks interval, and the CS group received one injection of CS. Western Ontario Rotator Cuff Index (WORC) was the primary outcome measure, while secondary outcome measures were the Visual Analogue Scale (VAS), Range of Motion (ROM) and need for cuff repair surgery, which were analyzed at interval of 6, 12, and 18 months.Results: A total of 75 patients were included in the analysis (PRP n = 35, CS n = 40). Mean follow-up was (PRP 21.1 ± 8.7 months vs CS 33.6 ± 16.3 months, p <0.001). Both groups showed improvement in WORC, VAS and ROM. No significant differences were detected between the two groups in any of the primary (WORC) or secondary outcomes during 6, 12 and 18 months (all p > 0.05). No adverse events were detected.Conclusion: Both treatments improve RCRSP patient’s symptoms, but none of them seems to result in a significant better outcome in this series of patients. PRP can be a safe and feasible alternative to CS in treatment of RCRSP even at long follow-up, to reduce local and systemic effects involved with CS injections.

The effectiveness of trigger point treatment in rotator cuff pathology: A randomized controlled double-blind study

2019 ◽  
Vol 32 (3) ◽  
pp. 519-527
Author(s):  
Yildiz Analay Akbaba ◽  
Ebru Kaya Mutlu ◽  
Suleyman Altun ◽  
Ezgi Turkmen ◽  
Tansu Birinci ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Trigger Point ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Randomized Controlled

A DOUBLE-BLIND STUDY OF THE EFFECTIVENESS OF LOW LEVEL LASER TREATMENT OF ROTATOR CUFF TENDINITIS

Rheumatology ◽  
1993 ◽  
Vol 32 (8) ◽  
pp. 740-742 ◽  
Author(s):  
P. VECCHIO ◽  
M. CAVE ◽  
V. KING ◽  
A. O. ADEBAJO ◽  
M. SMITH ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Laser Treatment ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Low Level ◽  
Low Level Laser ◽  
Rotator Cuff Tendinitis ◽  
Level Laser

Prior mood disorder diagnoses do not relate to current mood disorder symptoms or patient-reported disease severity in rotator cuff patients

2020 ◽  
pp. 175857322094702
Author(s):  
Eric Gibson ◽  
Justin LeBlanc ◽  
Marlis T Sabo
Keyword(s):  
Rotator Cuff ◽  
Mood Disorder ◽  
Disease Severity ◽  
Depression Scale ◽  
Patient Reported Outcome ◽  
Statistical Testing ◽  
Symptom Improvement ◽  
Western Ontario Rotator Cuff ◽  
Patient Reported ◽  
Current Mood

Background Surgery for rotator cuff syndrome does not always produce symptom improvement. Biological factors may explain some symptoms, but mood disorder symptoms may also contribute. The purpose of this study is to examine the interaction between disease severity, prevalence of mood disorder diagnoses, and current mood disorder symptoms in preoperative rotator cuff patients. Methods A prospective cohort of patients aged 35–75 years with unilateral rotator cuff disease awaiting surgery participated. Demographics, psychiatric history, the Hospital Anxiety & Depression Scale, and the Western Ontario Rotator Cuff index were collected. Descriptive and univariate statistical testing was performed. Results Of 140 participants (75M:65W) aged 55 ± 8 years, 34 reported a prior diagnosis of a mood disorder. There was a moderate positive relationship between disease severity and current depression and anxiety scores. Women were more likely to carry a diagnosis of a mood disorder, but there were no differences in current symptom levels between genders. No differences were found in patient-reported outcome measure scores between patients with and without a mood disorder diagnosis. Discussion Current mood disorder symptoms were associated with greater disease severity, whereas the presence of a past mood disorder diagnosis was not. Awareness of this relationship may reduce bias about past mood disorder diagnoses during decision-making.

Sign in / Sign up

Export Citation Format

Share Document