Subacromial Bursa Injection of Hyaluronate with Steroid in Patients with Peri-articular Shoulder Disorders
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Objective To investigate the additive effect of sono-guided subacromial bursa injection of hyaluronate with steroid in patients with peri-articular shoulder disorders. Method This prospective randomized controlled trial involved 26 patients who had shoulder pain. Group A,consisting of 13 patients, was treated with a sono-guided subacromial bursa injection containing a mixture of 0.5%lidocaine (5 ml) and triamcinolone 40 mg (1 ml), followed by injection with sodium hyaluronate (2 ml) once a week for 3 weeks. The other 13 patients (Group B) were treated with a sono-guided subacromial bursa injection containing a mixture of 0.5% lidocaine (5 ml) and triamcinolone 40 mg (1 ml) once a week for 3 weeks. The effects were assessed using a visual analogue scale (VAS) of shoulder pain, active range of motion (AROM), shoulder function assessment scale (SFA), shoulder disability questionnaire (SDQ) at study entry and every week from first injection until 4 weeks after the 1st injection (= 2 weeks after 3rd injection). Results (1) Demographic features and all parameters measured before injection did not show a significant diff erence between the 2 groups. (2) Statistically signifi cant improvements were shown in VAS, SFA, SDQ during the 1st, 2nd, and 4th week after the first injection in both groups (p<0.05). (3) SFA showed signifi cant improvement at 1 week after injection only in group A (p<0.05). (4) AROM of internal rotation showed signifi cant improvement at week 4 after the 1st injection only in group A (p<0.05). Conclusion Subacromial bursa injection of hyaluronate with steroid in patients with peri-articular shoulder disorders has additive effects on functional improvement of the aff ected shoulder, including the AROM of internal rotation.
Abstract
Objective To investigate the additive effect of sono-guided subacromial bursa injection of hyaluronate with steroid in patients with peri-articular shoulder disorders. Method This prospective randomized controlled trial involved 26 patients who had shoulder pain. Group A,consisting of 13 patients, was treated with a sono-guided subacromial bursa injection containing a mixture of 0.5%lidocaine (5 ml) and triamcinolone 40 mg (1 ml), followed by injection with sodium hyaluronate (2 ml) once a week for 3 weeks. The other 13 patients (Group B) were treated with a sono-guided subacromial bursa injection containing a mixture of 0.5% lidocaine (5 ml) and triamcinolone 40 mg (1 ml) once a week for 3 weeks. The effects were assessed using a visual analogue scale (VAS) of shoulder pain, active range of motion (AROM), shoulder function assessment scale (SFA), shoulder disability questionnaire (SDQ) at study entry and every week from first injection until 4 weeks after the 1st injection (= 2 weeks after 3rd injection). Results (1) Demographic features and all parameters measured before injection did not show a significant diff erence between the 2 groups. (2) Statistically signifi cant improvements were shown in VAS, SFA, SDQ during the 1st, 2nd, and 4th week after the first injection in both groups (p<0.05). (3) SFA showed signifi cant improvement at 1 week after injection only in group A (p<0.05). (4) AROM of internal rotation showed signifi cant improvement at week 4 after the 1st injection only in group A (p<0.05). Conclusion Subacromial bursa injection of hyaluronate with steroid in patients with peri-articular shoulder disorders has additive effects on functional improvement of the aff ected shoulder, including the AROM of internal rotation.
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