Antonio Frizziero1, Filippo Vittadini2, Michele Barazzuol2, Giuseppe Gasparre2, Paolo Finotti2, Andrea Meneghini2, Nicola Maffulli3,4, Stefano Masiero2. 1. Department of Physical and Rehabilitation Medicine, University of Padua, Padua, Italy - antonio.frizziero@unipd.it. 2. Department of Physical and Rehabilitation Medicine, University of Padua, Padua, Italy. 3. Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi, Salerno, Italy. 4. Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, London, UK.
Abstract
BACKGROUND: Rotator cuff tendinopathy is the most common cause of painful shoulder. The treatment is mainly conservative and several therapeutic approaches have been proposed, including NSAIDs, physiotherapy, injections and physical therapies. The aim of the current study was to compare the clinical effectiveness of low molecular weight hyaluronic acid (LMW-HA) injection versus low-energy extracorporeal shock-wave therapy (ESWT) until 3 months of follow-up for the management of painful non-calcific rotator cuff tendinopathies, evaluating also the trend over time between the groups. METHODS: A total of 34 patients affected by painful rotator cuff tendinopathy were randomly divided into 2 groups of 17 individuals. The first group (group A; mean age 58.2 years) underwent 3 injections of LMW-HA (Hyalgan®, 500-730 kDa), while in the second group (group B; mean age 58.5 years) the treatment protocol consisted of 4 sessions of low-energy ESWT. Pain level and function were assessed with the DASH and Constant-Murley questionnaires. Parameters were evaluated at baseline (V0), at the end of the treatment (V1) and after 3 months of follow-up (V2). RESULTS: Patients of both groups achieved statistically significant improve in pain and function (P<0.0001). Clinical outcome shows a different trend in time between group A and group B for DASH and Constant-Murley questionnaires. CONCLUSIONS:LMW-HA and low-energy ESWT are effective and safe in patients suffering from non-calcific rotator cuff tendinopathy until 3 months of follow-up. Intra-articular injections of LMW-HA provide prompt clinical improvement compared to ESWT, which results in more gradual improvement over time.
RCT Entities:
BACKGROUND: Rotator cuff tendinopathy is the most common cause of painful shoulder. The treatment is mainly conservative and several therapeutic approaches have been proposed, including NSAIDs, physiotherapy, injections and physical therapies. The aim of the current study was to compare the clinical effectiveness of low molecular weight hyaluronic acid (LMW-HA) injection versus low-energy extracorporeal shock-wave therapy (ESWT) until 3 months of follow-up for the management of painful non-calcific rotator cuff tendinopathies, evaluating also the trend over time between the groups. METHODS: A total of 34 patients affected by painful rotator cuff tendinopathy were randomly divided into 2 groups of 17 individuals. The first group (group A; mean age 58.2 years) underwent 3 injections of LMW-HA (Hyalgan®, 500-730 kDa), while in the second group (group B; mean age 58.5 years) the treatment protocol consisted of 4 sessions of low-energy ESWT. Pain level and function were assessed with the DASH and Constant-Murley questionnaires. Parameters were evaluated at baseline (V0), at the end of the treatment (V1) and after 3 months of follow-up (V2). RESULTS:Patients of both groups achieved statistically significant improve in pain and function (P<0.0001). Clinical outcome shows a different trend in time between group A and group B for DASH and Constant-Murley questionnaires. CONCLUSIONS:LMW-HA and low-energy ESWT are effective and safe in patients suffering from non-calcific rotator cuff tendinopathy until 3 months of follow-up. Intra-articular injections of LMW-HA provide prompt clinical improvement compared to ESWT, which results in more gradual improvement over time.
Authors: Maria Rita Citeroni; Maria Camilla Ciardulli; Valentina Russo; Giovanna Della Porta; Annunziata Mauro; Mohammad El Khatib; Miriam Di Mattia; Devis Galesso; Carlo Barbera; Nicholas R Forsyth; Nicola Maffulli; Barbara Barboni Journal: Int J Mol Sci Date: 2020-09-14 Impact factor: 5.923