Search Our Scientific Publications & Authors

J Orthop Surg Res 2020 Jun 3;15(1):204. Epub 2020 Jun 3.

Department of Orthopedic Surgery, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.

Background: Arthroscopic rotator cuff repair (ARCR) generally yields acceptable clinical results. Hyaluronic acid (HA), a high-molecular-weight polysaccharide, is present in the extracellular matrix of soft connective tissue and synovial fluid, and its injection is known to significantly improve pain and clinical outcomes after rotator cuff injury. Some studies have described the role of HA injections as conservative therapy for rotator cuff tears. Read More

Musculoskelet Surg 2020 May 22. Epub 2020 May 22.

Department of Orthopaedics, All India Institute of Medical Sciences, AIIMS, Virbhadra Marg, Rishikesh, Uttarakhand, 249201, India.

Purpose: Local subacromial infiltration with steroids is a common method of treatment of subacromial impingement syndrome. However, the use of steroids has concerns like tendon rupture, articular cartilage changes and infections. Local NSAIDs infiltration has recently been tried in literature. Read More

Arthrosc Sports Med Rehabil 2020 Apr 8;2(2):e161-e169. Epub 2020 Apr 8.

Tufts Medical Center, Boston, Massachusetts, U.S.A.

Purpose: To evaluate the in vitro effects of corticosteroid injections (CSIs) on rotator cuff tendon (RCT).

Methods: A systematic review of the MEDLINE database was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for all studies reporting on adverse biochemical and biomechanical effects of CSIs on RCT.

Results: Sixteen studies were identified that had been published in the last 15 years on the effects of corticosteroids on RCTs. Read More

Medicine (Baltimore) 2020 Apr;99(16):e19706

Department of Anesthesiology, The 960th Hospital of the People's Liberation Army Joint Logistice Support Force, Shandong, China.

Background: Intra-articular (IA) corticosteroid injection is a commonly used therapy for frozen shoulder (FS), but controversy still exists regarding the injection site with the best outcome. This randomized controlled trial is designed to determine whether corticosteroid injection into the subacromial space was not inferior to IA injection in patients with FS.

Methods: This study will be a single-center, randomized, and double-blinded trial. Read More

J Orthop 2020 May-Jun;19:89-92. Epub 2019 Nov 14.

VCU Medical Center Ambulatory Care Center, Virginia, USA.

Backgroud: the ideal route and accuracy of subacromial injections in shoulder pathologies are often questioned. This study aimed at comparing anterior and posterior injections in terms of subacromial space dye localization and diagnostic accuracy. We hypothesized that posterior injections would prove more accurate. Read More

Orthop J Sports Med 2020 Jan 3;8(1):2325967119892331. Epub 2020 Jan 3.

Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, USA.

Background: Rotator cuff pathology is the most common cause of shoulder pain in adults, accounting for nearly 70% of shoulder-related visits to clinicians. However, physical examination findings may be limited because of pain or patient inhibition.

Purpose: To establish whether a relationship exists between pain, range of motion, and strength in patients with a full-thickness rotator cuff tear. Read More

Turk J Med Sci 2020 02 13;50(1):205-212. Epub 2020 Feb 13.

Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Giresun University, Giresun, Turkey

Background/aim: The objective in this study is to assess the short-term effects of a single-session mobilization in addition to subacromial corticosteroid (SACS) injection in impingement syndrome.

Materials And Methods: The study was designed as a prospective randomized controlled single-blind, parallel group clinical trial. Patients (totally 84) were divided randomly into two groups equally. Read More

Cochrane Database Syst Rev 2019 12 9;12:CD013502. Epub 2019 Dec 9.

Monash University, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Melbourne, Australia.

Background: This review is one in a series of Cochrane Reviews of interventions for shoulder disorders.

Objectives: To synthesise the available evidence regarding the benefits and harms of rotator cuff repair with or without subacromial decompression in the treatment of rotator cuff tears of the shoulder.

Search Methods: We searched the CENTRAL, MEDLINE, Embase, Clinicaltrials. Read More

J Back Musculoskelet Rehabil 2020 ;33(3):387-396

Erenkoy Physical Therapy and Rehabilitation Hospital, Sports Medicine Clinic, Istanbul, Turkey.

Background: Injections are a good alternative to conventional treatment-resistant cases with rotator cuff (RC) lesions before operation. Currently, different injection methods are used in RC lesions.

Objective: To evaluate the efficacy of different injection methods (platelet-rich plasma [PRP], corticosteroid [COR] and prolotherapy [PRO]) in RC tendon lesions. Read More

Biomed Res Int 2019 15;2019:1274790. Epub 2019 Oct 15.

Department of Orthopedic Surgery, West China Hospital of Sichuan University, Sichuan University, Chengdu, Sichuan 610041, China.

Background: Adhesive capsulitis is one of the most well-known causes of pain and stiffness of the shoulder. Corticosteroid injections have been used for many years. However, it is still controversial where corticosteroid should be injected, whether subacromial or intra-articular. Read More

Medicine (Baltimore) 2019 Nov;98(45):e17933

Department of Neurology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hang Zhou, Zhe Jiang, PR China.

Hemiplegic shoulder pain (HSP), which occurs in most patients with hemiplegia, causes considerable distress and worsens outcomes in rehabilitation. Although they have received the treatments such as anti-inflammatory drugs or physical therapy, many of the individuals remain suffering from shoulder pain 6 months after acute stroke event. In this retrospective study, we evaluated the effectiveness of ultrasound guided subacromial-subdeltoid (SASD) bursa injections with botulinum toxin type A (BoNT/A) compared to steroids for refractory HSP. Read More

Orthop Rev (Pavia) 2019 09 30;11(3):8146. Epub 2019 Sep 30.

Epstein Center for Sports Medicine, Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA.

Rotator cuff disease is one of the most common causes of shoulder pain, yet controversy still exists regarding treatment of "irreparable" tears. Nonoperative management, including physical therapy and steroid injections, should be reserved for those without significant pain or functional impairment. Debridement may be used for low-demand patients, and should be performed with partial cuff repair, subacromial decompression, and/or acromioplasty to maximize outcomes. Read More

Med Princ Pract 2020 4;29(2):174-180. Epub 2019 Sep 4.

Department of Orthopaedics and Traumatology, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey.

Background: The objective of this study was to evaluate the efficacy of subacromial injections of collagenase and corticosteroid in rats with experimentally induced adhesive capsulitis.

Method: Thirty adult Wistar albino male rats were distributed into 3 groups of 10 rats each after stabilization of their shoulders for 3 weeks: the first group received a single dose of 0.002 mg (0. Read More

Scand J Pain 2019 12;20(1):167-174

School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Room E316, Anderson Stuart Building (F13), Sydney, NSW 2006, Australia.

Background and aims People with shoulder pain often present with abnormal shoulder muscle function. It is not known whether shoulder pain causes or is the result of muscle dysfunction. If pain leads to muscle dysfunction, therapeutic interventions that produce shoulder pain may be contraindicated. Read More

Int J Surg 2019 Aug 27;68:92-103. Epub 2019 Jun 27.

Department of Anesthesiology, Ganzhou People's Hospital, No. 18, Meiguan Avenue, Zhanggong District, Ganzhou City, 341000, China. Electronic address:

Objective: To compare the efficacy and safety of intra-articular injection and subacromial injection in the treatment of primary frozen shoulder (FS).

Methods: We conducted a systematic literature search for all relevant studies on Medline, Embase, Web of Science and Cochrane Central, up to April 2019 with no restrictions to language of publication. The primary outcome was visual analog scale (VAS) score, range of motion (ROM), and Constant shoulder score. Read More

Clin Orthop Surg 2019 Jun 9;11(2):192-199. Epub 2019 May 9.

Department of Orthopaedic Surgery, The Jikei University School of Medicine, Tokyo, Japan.

Background: The purpose of this study was to clarify the importance of preoperative pain control using corticosteroid injections in patients with persistent rest pain (RP) before arthroscopic rotator cuff repair (ARCR).

Methods: A total of 360 patients (374 shoulders) who underwent primary ARCR and were followed up for at least 2 years were enrolled. After one-to-one propensity score matching, 266 patients (145 men and 128 women, 273 shoulders) were included in the study. Read More

Arch Phys Med Rehabil 2019 11 29;100(11):2119-2128. Epub 2019 May 29.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

Objective: To compare dual-target injection with standard ultrasound (US)-guided subacromial injection in patients with subacromial impingement syndrome (SIS) and possible disorders of the biceps long-head tendons.

Design: Double-blind, randomized controlled trial.

Setting: Rehabilitation outpatient clinic. Read More

Medicine (Baltimore) 2019 May;98(21):e15552

The Department of Orthopedic Surgery, The First People's Hospital of Neijiang, Sichuan, China.

Background: Rotator cuff calcific tendinopathy (RCCT) is frequently diagnosed in patients with shoulder pain, but there is no consensus on its treatment such as rest, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, subacromial corticosteroid injection (SAI), extracorporeal shock wave therapy (ESWT), and ultrasound-guided percutaneous lavage (UGPL). The aim of the study was to compare the effectiveness of UGPL with other techniques in the treatment of RCCT.

Methods: Literature searches of PubMed, EMBASE, OVID, Cochrane Library, Web of Science, Chinese Biomedical Literature, Wanfang, Weipu Journal, and CNKI databases were performed up to August 2018. Read More

Maturitas 2019 May 31;123:9-14. Epub 2019 Jan 31.

University of Sydney, Sydney Adventist Hospital, Clinical School, Department of Orthopaedic Surgery, Sydney, NSW, Australia. Electronic address:

Rotator cuff tears (RCTs) are a common cause of shoulder pain and weakness in the elderly (age > 65yrs) and result in reduced quality of life, loss of income and a burden on health care. With the elderly population living longer there is a growing interest in the effective and efficient management of RCTs. In a majority of cases, the initial treatment is conservative, with physical therapy, analgesics and possibly corticosteroid or plasma rich protein injections. Read More

Ann Rheum Dis 2019 06 11;78(6):837-843. Epub 2019 Apr 11.

Department of Rheumatology, CHU Nantes, Nantes, France

Objective: Steroid injections are common after an ultrasound-guided puncture and lavage (UGPL) of calcific tendonitis of the rotator cuff. However, steroids may prevent calcification resorption and negatively affect tendon healing. Our study was designed to determine whether saline solution was non-inferior to steroids in the prevention of acute pain reactions in the week following UGPL. Read More

Orthop Traumatol Surg Res 2019 04 8;105(2):245-249. Epub 2019 Mar 8.

Hôpitaux universitaires Paris Île-de-France Ouest, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France; UFR des sciences de la santé, université de Versailles Saint-Quentin, 78035 Versailles, France.

Introduction: Despite improvements in technique and materials for rotator cuff repair, mean re-tear rates remain close to 30%. The aim of the present study was to assess injection of Autologous Conditioned Plasma (ACP™, Arthrex) for tendon healing after arthroscopic repair. The study hypothesis was that ACP™ improves the tendon-healing rate. Read More

J Shoulder Elbow Surg 2019 Jul 4;28(7):1291-1297. Epub 2019 Mar 4.

Department of Orthopedic Surgery, Hôpital Pierre-Paul Riquet, Toulouse, France.

Background: A bone landmark-based approach (LBA) to the distal suprascapular nerve (dSSN) block is an attractive "low-tech" method available to physicians with no advanced training in regional anesthesia or ultrasound guidance. The primary aim of this study was to validate the feasibility of an LBA to blockade of the dSSN by orthopedic surgeons using anatomic analysis. The secondary aim was to describe the anatomic features of the sensory branches of the dSSN. Read More

MedEdPORTAL 2018 09 15;14:10749. Epub 2018 Sep 15.

Associate Professor, General Internal Medicine, Wake Forest Baptist Health.

Introduction: Although musculoskeletal (MSK) complaints are very common in ambulatory clinics, internal medicine residents report low confidence in performing MSK examinations and intra-articular steroid injections. Our goal is to strengthen residents' MSK competence by using visual, auditory, and kinesthetic educational modalities during an academic half-day session.

Methods: Our intervention was a workshop/academic half-day session that included multimodal educational materials on common shoulder and knee MSK complaints. Read More

Am J Sports Med 2019 03 13;47(4):915-921. Epub 2019 Feb 13.

Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA.

Background: Corticosteroid injections are sometimes used in the postoperative period after shoulder arthroscopy; however, a well-defined safety profile has not been established.

Purpose: To examine the association between the timing of postoperative corticosteroid injections and rates of infection after shoulder arthroscopy.

Study Design: Cohort study; Level of evidence, 3. Read More

BMJ 2019 Feb 6;364:l294. Epub 2019 Feb 6.

Department of Orthopaedic Surgery and Traumatology, Joint Research, OLVG, Amsterdam, The Netherlands

Clinical Question: Do adults with atraumatic shoulder pain for more than 3 months diagnosed as subacromial pain syndrome (SAPS), also labelled as rotator cuff disease, benefit from subacromial decompression surgery? This guideline builds on to two recent high quality trials of shoulder surgery.

Current Practice: SAPS is the common diagnosis for shoulder pain with several first line treatment options, including analgesia, exercises, and injections. Surgeons frequently perform arthroscopic subacromial decompression for prolonged symptoms, with guidelines providing conflicting recommendations. Read More

J Shoulder Elbow Surg 2019 Mar 14;28(3):430-436. Epub 2019 Jan 14.

Townsville Hospital, Douglas, QLD, Australia; Greenslopes Private Hospital, Brisbane, QLD, Australia.

Hypothesis: We aimed to compare the clinical efficacy of a suprascapular nerve block (SSNB) versus subacromial injection (SA) for outpatient treatment of patients with symptomatic rotator cuff tears in a double-blinded, randomized controlled trial using sealed-envelope randomization.

Methods: A total of 42 participants with symptomatic partial- and full-thickness rotator cuff tears quantified by ultrasound or magnetic resonance imaging received either an ultrasound-guided SSNB or SA. The primary outcome measure was shoulder function measured by the modified Constant-Murley (CM) score and the secondary outcome was the pain score measured by a visual analog scale at 2, 6, and 12 weeks after injection. Read More

Musculoskeletal Care 2019 03 8;17(1):13-22. Epub 2019 Jan 8.

Rehabilitation Department, John Hopkins Healthcare Aramco, Dhahran, Kingdom of Saudi Arabia.

Background: Subacromial impingement syndrome (SAIS) is the most common cause of shoulder pain and is costly, in terms of disability and health service provision. Research evidence suggests that, generally, the anterior, lateral and posterior approaches are used by clinicians for subacromial injection. However, it is uncertain which of these approaches is more effective than the other in the management of SAIS. Read More

Arthroscopy 2019 02 3;35(2):325-331. Epub 2019 Jan 3.

Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.. Electronic address:

Purpose: To determine whether an association exists between preoperative shoulder injections and reoperations in patients undergoing arthroscopic rotator cuff repair (aRCR).

Methods: The PearlDiver Patient Records Database was reviewed for Humana-insured patients undergoing aRCR after a shoulder injection. Two matched groups were created: aRCR within 1 year of injection (n = 12,054) and aRCR without prior injection within 1 year of surgery (n = 12,054). Read More

Arthroscopy 2019 01 22;35(1):45-50. Epub 2018 Nov 22.

Department of Orthopedic Surgery, University of Virginia, Charlottesville, Virginia, U.S.A.. Electronic address:

Purpose: To identify any dose-dependent association between the use of subacromial corticosteroid injections within a year before rotator cuff repair (RCR) and subsequent need for revision rotator cuff surgery.

Methods: Two large administrative databases were queried for patients undergoing arthroscopic RCR. A minimum of 1 year of preoperative database exposure and 2 years of postoperative database follow-up were required for inclusion. Read More

J Ultrason 2018 ;18(74):234-239

Oxford University and St Lukes Radiology Oxford Ltd, Oxford, UK.

Diagnosis is crucial in decision-making when treating a patient with shoulder pain. Ultrasound is also very important in the diagnostic and therapeutic pathway, especially when surgery is being considered. This article outlines the diagnostic pathway using the patient's history, physical examination and ultrasound examination. Read More

Skeletal Radiol 2019 Aug 16;48(8):1269-1274. Epub 2018 Nov 16.

Orthopaedic Department, Chiltern Hospital, Great Missenden, UK.

Objective: To describe and evaluate the outcome following shoulder manipulation under rotator interval block for the treatment of adhesive capsulitis.

Materials And Methods: Patients with adhesive capsulitis referred by our local orthopaedic shoulder surgeons consented to targeted ultrasound-guided injection of the glenohumeral joint via the rotator interval. Inclusion criteria included a failure to respond to conservative treatment and the absence of a full-thickness rotator cuff tear. Read More

Orthopedics 2019 Jan 14;42(1):e44-e50. Epub 2018 Nov 14.

The authors sought to compare the accuracy and effectiveness of the mid-lateral and posterior routes of subacromial injection. They conducted a prospective randomized study involving 50 shoulders scheduled to receive subacromial injection via the midlateral or posterior route. After injection, a blinded musculoskeletal radiologist interpreted the radiographs. Read More

Zhonghua Wai Ke Za Zhi 2018 Oct;56(10):781-785

Department of Orthopedics, Tianjin Fifth Central Hospital, Tianjin 300450, China.

To evaluate the clinical effects of ultrasound-guided subacromial injection of two drugs in treatment of subacromial impingement syndrome. This was a randomized controlled trial study, prospective collection of patients' data who were diagnosed as subacromial impingement syndrome at Orthopedic of Tianjin Fifth Central Hospital from January 2015 to August 2017. To ensure the randomness of the study, patients were randomized into two groups using a random number table. Read More

Am J Sports Med 2018 11 12;46(13):3142-3154. Epub 2018 Oct 12.

Department of Laboratory Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Dongjak-gu, Seoul, Republic of Korea.

Background: Although platelet-rich plasma (PRP) is a popular option for rotator cuff disease, the underlying mechanism of PRP and its clinical indications are unclear. Further, some kinds of PRP might be detrimental to patients. Allogenic PRP prepared through a standardized process and fully characterized could eliminate variations in PRP as well as uncertainties regarding its use in each patient, which could provide clues about its mechanism of action and indications for its use. Read More

Acta Chir Orthop Traumatol Cech 2018 ;85(4):261-265

Ortopedicko-traumatologické oddělení, Nemocnice Znojmo.

PURPOSE OF THE STUDY This study aimed to explore the effects of new therapeutic procedures in patients with shoulder impingement syndrome. The primary goal of the study was to confirm the hypothesis that the application of the platelet-rich plasma (PRP) in patients with shoulder impingement syndrome will have a positive effect on both the subjective and objective evaluation of their condition. The clinical condition before and after the treatment was evaluated. Read More

Med Sci Sports Exerc 2019 02;51(2):227-233

Department of Cardiology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Huazhong University of Science and Technology, Wuhan, CHINA.

Purpose: The treatment of partial-thickness rotator cuff tears (PTRCT) remains controversial. Few studies have focused on the conservative and new measurements of small to medium PTRCT. The use of sodium hyaluronate (SH) or platelet-rich plasma (PRP) as a method for rotator cuff repair requires further investigation. Read More

Arthroscopy 2018 10 6;34(10):2765-2774. Epub 2018 Sep 6.

Lovisenberg Diaconal Hospital, Oslo, Norway.

Purpose: The aim of this study was to compare clinical and radiologic results among patients with 3 versus 6 weeks of immobilization after arthroscopic rotator cuff (RC) repair in a prospective randomized controlled non-inferiority trial.

Methods: One hundred twenty patients were included after RC surgery for a small- to medium-sized tear of supraspinatus and upper infraspinatus tendons. Group A was immobilized in a simple sling for 3 weeks, and group B had a brace with a small abduction pillow with the arm in neutral position for 6 weeks. Read More

Acta Ortop Mex 2018 Mar-Apr;32(2):70-75

Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. España.

Objective: Our purpose was to assess the effectiveness of hyaluronic acid infiltrations for chronic shoulder pain as an alternative to the non-surgical and surgical treatments that are currently available.

Material And Methods: This is a prospective study of 80 consecutive patients suffering from chronic shoulder pain followed for twelve months. Five subacromial hyaluronic acid injections on five consecutive weeks were administrated to all patients. Read More

Medicine (Baltimore) 2018 Aug;97(35):e12078

Background: Hemiplegic shoulder pain (HSP) is one common complication after stroke. The interferes with the functionality of the affected shoulder in patients with stroke during rehabilitation. Hyaluronic acid (HA) could have positive effects on pain relief and shoulder motion in stroke patients with hemiplegic shoulders. Read More

J Pain Res 2018 25;11:1239-1245. Epub 2018 Jun 25.

Physical Medicine and Rehabilitation Unit, Ospedali Riuniti, Università di Foggia, Foggia,

Introduction: Shoulder pain is one of the most common musculoskeletal diseases, and can be due to glenohumeral osteoarthritis, rotator cuff tear, impingement, tendinitis, adhesive capsulitis, and subacromial bursitis. Several therapies have been proposed, including steroids, nonsteroidal anti-inflammatory drugs, intra-articular injections, and physical therapies. Many published studies have reported on the employment of botulinum toxin type A (BoNT-A) to reduce pain in subjects with neurological and musculoskeletal diseases by inhibiting substance P release and other inflammatory factors. Read More

Shoulder Elbow 2018 Jul 5;10(3):170-178. Epub 2017 Jun 5.

Orthopaedic Research Institute, St George Hospital Campus, Sydney, NSW, Australia.

Background: Subacromial corticosteroid injections are frequently performed for pain associated with supraspinatus tendinopathy. Glucose prolotherapy has been used clinically for multiple tendinopathies and is hypothesized to be an alternate injection therapy for supraspinatus tendinopathy.

Methods: A prospective, randomized, double blinded clinical trial was conducted. Read More

Clin Radiol 2018 08 18;73(8):760.e7-760.e12. Epub 2018 Jun 18.

Department of Musculoskeletal Radiology, Leeds Teaching Hospitals, Great George Street, Leeds, LS1 3EX, UK.

Aim: To assess shoulder pain and disability in patients undergoing corticosteroid injection into the subacromial-subdeltoid (SA-SD) bursa under ultrasound guidance, evaluating both short and long-term outcomes.

Materials And Methods: In this prospective, longitudinal, analytical study 376 patients referred for SA-SD bursa injection during a 6 month period were asked to complete a questionnaire assessing shoulder pain and disability in the form of the Shoulder Pain and Disability Index (SPADI). Patients were reassessed at 6 weeks and 12 months post-injection. Read More

J Clin Orthop Trauma 2018 Mar 7;9(Suppl 1):S80-S85. Epub 2017 Feb 7.

Department of Orthopaedics, GTB Hospital & UCMS, Delhi 110095, India.

Objective: Impingement syndrome is the most common differential in a patient presenting to an orthopaedic OPD with shoulder pain. Impingement syndrome is often managed with subacromial corticosteroid injection, which can be instilled using either landmark guided (LMG) approach or with the assistance of ultrasound (US). This study was envisaged to enquire whether ultrasound assistance improves the accuracy, efficacy or safety profile of the injection. Read More

Orthop Clin North Am 2018 Apr 19;49(2):231-239. Epub 2017 Dec 19.

Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA.

Rotator cuff disease affects a large proportion of the overall population and encompasses a wide spectrum of pathologies, including subacromial impingement, rotator cuff tendinopathy or tear, and calcific tendinitis. Various injection therapies have been used for the treatment of rotator cuff disease, including corticosteroid, prolotherapy, platelet-rich plasma, stem cells, and ultrasound-guided barbotage for calcific tendinitis. However, the existing evidence for these therapies remains controversial or sparse. Read More

PeerJ 2018 23;6:e4400. Epub 2018 Feb 23.

Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Hvidovre, Denmark.

Background: Impaired patient-reported shoulder function and pain, external-rotation strength, abduction strength, and abduction range-of-motion (ROM) is reported in patients with subacromial impingement (SIS). However, it is unknown how much strength and ROM improves in real-life practice settings with current care. Furthermore, outcomes of treatment might depend on specific rehabilitation parameters, such as the time spent on exercises (exercise-time), number of physiotherapy sessions (physio-sessions) and number of corticosteroid injections, respectively. Read More

Am J Sports Med 2018 04 22;46(5):1097-1105. Epub 2018 Feb 22.

Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.

Background: Subacromial pain pumps are used for analgesia after arthroscopic rotator cuff surgery. However, there is controversy about myotoxic or tendinotoxic effects of local anesthetics.

Hypothesis: Ropivacaine administered via a subacromial pain pump would have no adverse effect on rotator cuff tendon healing, fatty degeneration, strength, or functional outcomes after arthroscopic repair. Read More

Eur J Orthop Surg Traumatol 2018 Aug 8;28(6):1079-1087. Epub 2018 Feb 8.

Sport and Orthopedic Center, Samitivej Hospital, Bangkok, Thailand.

Background: In symptomatic tendinosis, a corticosteroid injection into the subacromial space is a palliative treatment option. This study compares high volumes (10 cc) of local anesthetic (LA) combined with triamcinolone acetate (TA) with low volumes (4 cc) of LA combined with TA to see whether the latter would provide similar pain, function and complication outcomes for subacromial injections in patients with impingement syndrome.

Materials And Methods: This single-center, randomized, single-blind, non-inferiority trial included patients with shoulder pain and positive multiple clinical tests supporting the diagnosis of impingement syndrome. Read More

J Res Pharm Pract 2017 Oct-Dec;6(4):223-227

Departement of Internal Medicine, Poursina Hakim Research Institute for Health Care Development, Isfahan, Iran.

Objective: Subacromial impingement syndrome is the most common cause of shoulder pain and restriction in range of motion in the world. The aim of this study was to compare the efficacy of subacromial injection of ketorolac with the injection of corticosteroid for the treatment of subacromial impingement syndrome.

Methods: A total of forty patients were randomly allocated into two groups. Read More

J Shoulder Elbow Surg 2018 May 1;27(5):771-776. Epub 2018 Feb 1.

Orthopaedic Department, Shoulder-Elbow Section, University of Düsseldorf, Düsseldorf, Germany.

Hypothesis: We hypothesized that the prevalence of Propionibacterium acnes in patients undergoing primary shoulder arthroscopy is equal in the glenohumeral space compared with the subacromial space.

Methods: Patients aged 18 years or older with shoulder arthroscopies were included. The exclusion criteria were prior shoulder operations, complete rotator cuff tears, systemic inflammatory diseases, tumors, shoulder injections within 6 months of surgery, and antibiotic therapy within 14 days preoperatively. Read More

Br J Sports Med 2018 Apr 5;52(8):497-504. Epub 2018 Jan 5.

School of Health and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, UK.

Objective: To compare the effectiveness of corticosteroid injections to local anaesthetic injections in the management of rotator cuff-related shoulder pain (RCRSP).

Design: Systematic review with best evidence synthesis.

Data Sources: The Cochrane, PubMed, CINAHL Plus, PEDro and EMBASE electronic databases were searched (inception until 8 June 2017). Read More