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Clinical efficacy of ultrasound-guided hyaluronic acid injections in patients with supraspinatus tendon tear


1, 2, 3, 4, 5, 6

 

  1. Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, “Carlo Urbani” Hospital, Jesi, Italy. edoardocipolletta@gmail.com
  2. Radiology Department, A.O. Ospedali Riuniti Marche Nord, Pesaro, Italy.
  3. Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, “Carlo Urbani” Hospital, Jesi, Italy; and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, UK.
  4. Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, “Carlo Urbani” Hospital, Jesi, Italy.
  5. Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, “Carlo Urbani” Hospital, Jesi, Italy.
  6. Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, “Carlo Urbani” Hospital, Jesi, Italy.

CER13387
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PMID: 32896264 [PubMed]

Received: 31/03/2020
Accepted : 15/06/2020
In Press: 04/09/2020

Abstract

OBJECTIVES:
To evaluate the clinical efficacy of ultrasound (US)-guided soft tissue adapted biocompatible hyaluronic acid (STABHA) injections in the subacromial-subdeltoid bursa of patients with supraspinatus tendon tear.
METHODS:
In this prospective study, patients with a symptomatic partial-thickness or small full-thickness supraspinatus tendon tear, diagnosed by US, were consecutively enrolled. Patients received one injection at baseline visit and one after 2 weeks and performed rehabilitation therapy. Clinical assessment was performed with visual analogue scale (VAS) for pain, Constant-Murley Scale (CMS), and patient reported efficacy on a 0–4 Likert scale. Patients were examined at baseline, at week 2 and at week 12.
RESULTS:
Thirty patients were enrolled. Sixteen (53.3%) and 19 (63.3%) patients reported significant improvement at week 12 in pain and function, respectively. Reduction in VAS pain was statistically significant both at week 2 and at week 12 in comparison with baseline visit (mean-difference -27.2 and -36.8, respectively, p<0.01). The same trend was observed with CMS (mean-difference 17.7 and 19.8, respectively, p<0.01). At week 12, 18 patients (60.0%) reported a subjective improvement. At week 12, in non-responders (n=14) US detected inflammatory changes and/or progression of tendon tear in 7 (50.0%) patients and no relevant changes in 7 (50.0%).
CONCLUSIONS:
US-guided STABHA injections followed by rehabilitation therapy were found effective in improving both pain and shoulder function at the 12-week follow-up. In half of the non-responders, US allowed the detection of US findings responsible for treatment failure.

Rheumatology Article