ORIGINAL ARTICLE

Randomised controlled trial of single, subacromial injection of methylprednisolone in patients with persistent, post-traumatic impingment of the shoulder

J J McInerney¹, J Dias², S Durham³ and A Evans²

¹ Emergency Department, Mater Misericordiae Hospital, Dublin, Republic of Ireland
² Leicester Royal Infirmary, Leicester, UK
³ Royal Lancaster Infirmary, Lancaster, UK

Correspondence to:
Correspondence to:
Mr J J McInerney, Emergency Department, Mater Misericordiae Hospital, Eccles Street, Dublin D4, Republic of Ireland;
emergmedlri{at}hotmail.com

Objective: To evaluate the impact on recovery, of single subacromial injection of methylprednisolone in patients with persistent, post-traumatic impingement of the shoulder.

Design: Randomised, controlled study.

Setting: Large accident and emergency department in Leicester, UK.

Participants: 98 patients with persistent, post-traumatic impingement of the shoulder.

Intervention: Single subacromial injection of methylprednisolone with bupivicaine (group S, n=54) or bupivicaine only (group C, n=44).

Main outcome measures: Pain using a 10 cm visual analogue scale (VAS) and active shoulder abduction.

Results: Comparison of pain scores by the 10 cm VAS between group and group C showed no statistical difference at 3, 6, or 12 weeks. Mean patient pain scores at 12 weeks were 1.38 in both groups (p=0.99). There were 16 patients in group S (mean age 52 years) with a 10 cm VAS greater than 1 (95% CI CI 0.17 to 0.43), compared with 13 patients (mean age 57 years) in group C (95% CI 0.17 to 0.45). Comparison of active shoulder abduction between group S and group C showed no statistical difference at 3, 6, or 12 weeks. Mean active abduction at 12 weeks was 168.9° in group S and 170.3° in group C (p=0.8). There were 10 patients in group S (mean age 60.5) with active abduction less than 170 at 12 weeks (95% CI 0.09 to 0.31), compared with five patients (mean age 62 years) in group C (95% CI 0.04 to 0.24).

Conclusions: Single subacromial injection of methylprednisolone has no beneficial impact on reducing the pain, or the duration of immobility in patients with persistent post-traumatic impingement of the shoulder

Keywords: corticosteroids; impingement; injection; shoulder

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Hambly, N., Fitzpatrick, P., MacMahon, P., Eustace, S. (2007). Rotator Cuff Impingement: Correlation Between Findings on MRI and Outcome After Fluoroscopically Guided Subacromial Bursography and Steroid Injection. Am. J. Roentgenol. 189: 1179-1184 [Abstract] [Full Text]  
• Koester, M. C., Dunn, W. R., Kuhn, J. E., Spindler, K. P. (2007). The Efficacy of Subacromial Corticosteroid Injection in the Treatment of Rotator Cuff Disease: A Systematic Review. J Am Acad Orthop Surg 15: 3-11 [Abstract] [Full Text]  
• (2003). Robin Goodfellow (42-10). Rheumatology (Oxford) 42: 1277-1277 [Full Text]  
• Marcovitch, H. (2003). What's new this month in BMJ Journals. BMJ 326: 1353-1353 [Full Text]