Subacromial corticosteroid injection versus subcutaneous 5% dextrose in patients with chronic rotator cuff tendinopathy: A short-term randomized clinical trial
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(12):17 Interv Med Appl Sci. 2020.16-Sep.What this means for my practice?
Results of this trial suggest that dextrose prolotherapy may provide greater pain relief compared to intra-articular corticosteroid injections for patients suffering from chronic rotator cuff tendinopathy at 1 month follow-up. This randomized controlled trial was limited by the lack of variability in measuring outcomes (i.e., pain, function), lack of statistical analysis utilized for comparing range of motion scores, and short follow-up of 1 month. Therefore, future randomized controlled trials including variable outcome measures, and long-term follow-up (≥6 months) are needed to confirm the findings of this study.
Study Summary
Sixty patients with chronic rotator cuff (RC) tendinopathy were randomized to receive an intra-articular corticosteroid injection (n=30) or prolotherapy consisting of subcutaneous injections of dextrose (n=30). Outcomes of interest included pain measured on a visual analogue scale (VAS), % of patients achieving a clinically significant reduction (≥2.8) in VAS pain scores, and range of motion (i.e., external rotation, abduction, and flexion) at 1-month follow-up. Results revealed that VAS pain at 1 month follow-up was not statistically significantly different between the corticosteroid and prolotherapy groups (p=0.052). However, a higher % of patients achieved a clinically significant reduction in VAS pain in the prolotherapy group vs corticosteroid group (p=0.046) at 1 month follow-up. Interestingly, range of motion in flexion, abduction, and external rotation were higher in the corticosteroid group vs. prolotherapy at 1 month follow-up. No patient in either group reported an adverse event.
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