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Clinical efficacy of ultrasound-guided hyaluronic acid injections in patients with supraspinatus tendon tear
E. Cipolletta1, R. Mashadi Mirza2, A. Di Matteo3, M. Di Carlo4, W. Grassi5, E. Filippucci6
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, “Carlo Urbani” Hospital, Jesi, Italy. edoardocipolletta@gmail.com
- Radiology Department, A.O. Ospedali Riuniti Marche Nord, Pesaro, Italy.
- 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.
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, “Carlo Urbani” Hospital, Jesi, Italy.
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, “Carlo Urbani” Hospital, Jesi, Italy.
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, “Carlo Urbani” Hospital, Jesi, Italy.
CER13387
2021 Vol.39, N°4
PI 0769, PF 0774
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PMID: 32896264 [PubMed]
Received: 31/03/2020
Accepted : 15/06/2020
In Press: 04/09/2020
Published: 08/07/2021
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.
