Fernando Contreras1, Haydée C Brown2, Robert G Marx2. 1. Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA ; Apartado 99-1000 San José, San José, Costa Rica. 2. Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
Abstract
BACKGROUND: The use of subacromial corticosteroid injection (CSI) to treat rotator cuff tendinopathy is controversial. We hypothesized that characteristics such as activity level, American Shoulder and Elbow Surgeons (ASES) score, duration of symptoms, and status of the rotator cuff may be prognostic factors for resolution of symptoms postinjection. METHODS: During a 12-month period, consecutive patients with rotator cuff disease were analyzed. Patients received subacromial CSI, oral NSAIDs, and physical therapy. Baseline ASES score, simple shoulder test, an activity scale, and demographic data were recorded. Patients who remained symptomatic and were indicated for surgery were considered failures. Patients that did not undergo surgery were reassessed after a minimum of 1 year. RESULTS: Forty-nine patients met our criteria. Follow-up was obtained for 81.6%. Sixteen cases (40%) failed conservative treatment at final follow-up (22.4 ± 11 months). CSI were successful in 76.2% of males and 45% of females (p = 0.04). Full-thickness tears were present in 8% of the patients with symptom resolution and 25% of those that failed conservative treatment (p = 0.29). No significant difference was found in age, hand dominance, duration of symptoms, or any of the scoring systems. CONCLUSION: It is difficult to predict outcomes after CSI. Our treatment strategy showed a 40% failure rate.
BACKGROUND: The use of subacromial corticosteroid injection (CSI) to treat rotator cuff tendinopathy is controversial. We hypothesized that characteristics such as activity level, American Shoulder and Elbow Surgeons (ASES) score, duration of symptoms, and status of the rotator cuff may be prognostic factors for resolution of symptoms postinjection. METHODS: During a 12-month period, consecutive patients with rotator cuff disease were analyzed. Patients received subacromial CSI, oral NSAIDs, and physical therapy. Baseline ASES score, simple shoulder test, an activity scale, and demographic data were recorded. Patients who remained symptomatic and were indicated for surgery were considered failures. Patients that did not undergo surgery were reassessed after a minimum of 1 year. RESULTS: Forty-nine patients met our criteria. Follow-up was obtained for 81.6%. Sixteen cases (40%) failed conservative treatment at final follow-up (22.4 ± 11 months). CSI were successful in 76.2% of males and 45% of females (p = 0.04). Full-thickness tears were present in 8% of the patients with symptom resolution and 25% of those that failed conservative treatment (p = 0.29). No significant difference was found in age, hand dominance, duration of symptoms, or any of the scoring systems. CONCLUSION: It is difficult to predict outcomes after CSI. Our treatment strategy showed a 40% failure rate.
Authors: M Rafii; H Firooznia; O Sherman; J Minkoff; J Weinreb; C Golimbu; R Gidumal; R Schinella; K Zaslav Journal: Radiology Date: 1990-12 Impact factor: 11.105
Authors: Lori A Michener; Jeffrey S Abrams; Kellie C Huxel Bliven; Sue Falsone; Kevin G Laudner; Edward G McFarland; James E Tibone; Charles A Thigpen; Timothy L Uhl Journal: J Athl Train Date: 2018-03 Impact factor: 2.860