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A double-blind randomized controlled trial comparing the effects of subacromial injection with corticosteroid versus NSAID in patients with shoulder impingement syndrome
- Source :
- Journal of Shoulder and Elbow Surgery. 22:595-601
- Publication Year :
- 2013
- Publisher :
- Elsevier BV, 2013.
-
Abstract
- Hypothesis The objective of this study was to compare the efficacy of subacromial injection of triamcinolone compared to injection of ketorolac in the treatment of external shoulder impingement syndrome. Methods Thirty-two patients diagnosed with external shoulder impingement syndrome were included in this double-blinded randomized controlled clinical trial. Each patient was randomized into the steroid group or nonsteroidal anti-inflammatory drugs (NSAID) group. The steroid syringe contained 40 mg triamcinolone; and the NSAID syringe contained 60 mg ketorolac. Each patient was evaluated in terms of arc of motion, visual analog scale (VAS) for evaluating pain, and the UCLA (The University of California at Los Angeles) shoulder rating scale. Results At 1 month follow-up, both treatment arms resulted in increased range of motion and decreased pain. The steroid group decreased in active abduction while the NSAID group increased (steroid: 134°, NSAID: 151°, P = .03). The mean improvement in the UCLA shoulder rating scale at 4 weeks was 7.15 for the NSAID group and 2.13 for the steroid group ( P = .03). Subgroup analysis of the UCLA scale demonstrated an increase in both forward flexion strength ( P = .04) and patient satisfaction ( P = .03) in the NSAID group. No significant difference could be seen in all other outcome measures. Conclusion In this study, an injection of ketorolac resulted in greater improvements in the UCLA shoulder rating scale than an injection of triamcinolone at 4 weeks follow-up. While both triamcinolone and ketorolac are effective in the treatment of isolated subacromial impingement, ketorolac appears to have equivalent if not superior efficacy; all the while decreasing patient exposure to the potential side-effects of corticosteroids.
- Subjects :
- Adult
Male
medicine.medical_specialty
Triamcinolone acetonide
medicine.drug_class
Visual analogue scale
Triamcinolone
Injections, Intra-Articular
law.invention
Young Adult
Patient satisfaction
Double-Blind Method
Randomized controlled trial
law
medicine
Humans
Orthopedics and Sports Medicine
Glucocorticoids
business.industry
Anti-Inflammatory Agents, Non-Steroidal
General Medicine
Middle Aged
Surgery
Ketorolac
Shoulder Impingement Syndrome
Anesthesia
Corticosteroid
Female
business
Range of motion
medicine.drug
Subjects
Details
- ISSN :
- 10582746
- Volume :
- 22
- Database :
- OpenAIRE
- Journal :
- Journal of Shoulder and Elbow Surgery
- Accession number :
- edsair.doi.dedup.....7451305da34d05ff89e516f6392b337c