Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, "Carlo Urbani" Hospital, Jesi, Italy.
Radiology Department, A.O. Ospedali Riuniti Marche Nord, Pesaro, Italy.
Clin Exp Rheumatol. 2021 Jul-Aug;39(4):769-774. doi: 10.55563/clinexprheumatol/cyiyy3. Epub 2020 Sep 4.
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.
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.
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%).
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.
评估超声引导下软组织适应型生物相容性透明质酸（STABHA）注射治疗肩袖肌腱撕裂患者肩峰下-三角肌下滑囊的临床疗效。
在这项前瞻性研究中，连续纳入经超声诊断为部分厚度或小全层肩袖肌腱撕裂且有症状的患者。患者在基线就诊时接受一次注射，在 2 周后接受一次注射，并进行康复治疗。临床评估采用视觉模拟评分（VAS）评估疼痛、Constant-Murley 评分（CMS）和患者 0-4 级 Likert 量表报告的疗效。患者在基线、2 周和 12 周时接受检查。
共纳入 30 例患者。16 例（53.3%）和 19 例（63.3%）患者在 12 周时报告疼痛和功能显著改善。与基线相比，VAS 疼痛在第 2 周和第 12 周均有统计学显著降低（平均差值分别为-27.2 和-36.8，p<0.01）。CMS 也观察到类似的趋势（平均差值分别为 17.7 和 19.8，p<0.01）。在第 12 周，18 例（60.0%）患者报告主观改善。在第 12 周，在无反应者（n=14）中，7 例（50.0%）患者的 US 检测到炎症改变和/或肌腱撕裂进展，7 例（50.0%）患者未发现相关变化。
超声引导下 STABHA 注射联合康复治疗在 12 周随访时发现可有效改善疼痛和肩部功能。在一半的无反应者中，US 可检测到导致治疗失败的 US 表现。
