naa a22 4500 510818358 CHVBK 20180411083519.0 cr unu---uuuuu 180411e20130601xx s 000 0 eng 10.1007/s12306-013-0259-y doi (NATIONALLICENCE)springer-10.1007/s12306-013-0259-y Ultrasound-guided subacromial injections of sodium hyaluronate for the management of rotator cuff tendinopathy: a prospective comparative study with rehabilitation therapy [Elektronische Daten] [G. Merolla, P. Bianchi, G. Porcellini] Background: Rotator cuff (RC) tendinopathy is a common cause of pain and shoulder dysfunction. The literature evidence suggests that a combination of overuse and extrinsic compression may induce chronic RC tendinopathy. Aim of the current study was to compare the results of subacromial sodium hyaluronate injections with rehabilitation therapy. Materials and methods: We enrolled 48 patients (M/F: 26/22; mean age: 50years; shoulder right/left: 29/19) with persistent shoulder pain for at least 4months. Exclusion criteria were as follows: RC tear, calcifying tendinitis, glenohumeral instability, osteoarthritis, rheumatic diseases, physical therapy and/or injection in the previous 4months, shoulder surgery, anesthetic nerve block, trauma, and severe medical diseases. The included subjects received either two ultrasound-guided subacromial hyaluronic acid (HA) injections (25 patients, HA group) at baseline and 14days, or underwent rehabilitation therapy (23 patients, Physio group) including active shoulder mobilization, soft tissue stretching and humeral head positioner and propeller muscles strengthening for 30days (3 sessions every week). Clinical assessment of shoulder function was performed with visual analog scale score for pain (0-100), Oxford Shoulder Score (OSS), and Constant-Murley Score (CS). Overall, patients were examined at baseline, week 2, week 4, week 12, and week 24. Statistical significance was set at 5% (p<0.05). Results: Reduction in overall pain in the HA group was statistically significant at week 2 (p<0.05) week 4 (p<0.05), week 12 comparing to baseline. Similarly, pain subscores (at night and with activity) were significantly lower at week 2 (p<0.05), week 4 (p<0.05), and week 12 (p<0.05), respectively. In the Physio group, pain decreased significantly at week 2 (p<0.05) but not maintained at week 4 (p>0.05), week 12 (p>0.05), and week 24 (p>0.05). CS and OSS in the HA group increased significantly at week 2 (p<0.05), week 4 (p<0.05), and week 12 (p<0.05). A non-statistically significant increase in clinical scores was found at week 24 (p>0.05). A significant improvement of CS and OSS we found in the Physio group at week 2 (p<0.05), but not at weeks 4, 12, and 24 (p>0.05). Conclusions: Subacromial HA injections could be an effective and safe alternative treatment for patients suffering from RC tendinopathy. We believe that the results of this study are encouraging but not lasting and we might suppose that a series of three to four subacromial sodium hyaluronate injections could provide good mid- and long-term clinical benefits. Istituto Ortopedico Rizzoli, 2013 Shoulder nationallicence Injection nationallicence Sodium hyaluronate nationallicence Rotator cuff nationallicence Tendinopathy nationallicence Merolla G. Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, Via L. V. Beethowen 46, Cattolica, Italy aut Bianchi P. Department of Orthopedics, Traumatology, Rehabilitation and Plastic Surgery, Second University of Naples, Naples, Italy aut Porcellini G. Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, Via L. V. Beethowen 46, Cattolica, Italy aut MUSCULOSKELETAL SURGERY Springer Milan 97(2013-06-01), 49-56 2035-5106 97<49 2013 97 12306 https://doi.org/10.1007/s12306-013-0259-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12306-013-0259-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Merolla G. Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, Via L. V. Beethowen 46, Cattolica, Italy aut NATIONALLICENCE 700 1- Bianchi P. Department of Orthopedics, Traumatology, Rehabilitation and Plastic Surgery, Second University of Naples, Naples, Italy aut NATIONALLICENCE 700 1- Porcellini G. Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, Via L. V. Beethowen 46, Cattolica, Italy aut NATIONALLICENCE 773 0- MUSCULOSKELETAL SURGERY Springer Milan 97(2013-06-01), 49-56 2035-5106 97<49 2013 97 12306 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer