Randomised controlled trial of single, subacromial injection of methylprednisolone in patients with persistent, post-traumatic impingment of the shoulder.
OBJECTIVE
To evaluate the impact on recovery, of single subacromial injection of methylprednisolone in patients with persistent, post-traumatic impingement of the shoulder.


METHODS
Randomised, controlled study.


METHODS
Large accident and emergency department in Leicester, UK.


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


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


METHODS
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 degrees in group S and 170.3 degrees 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
Emergency Department, Mater Misericordiae Hospital, Dublin, Republic of Ireland. Leicester Royal Infirmary, Leicester, UK. emergmedlri@hotmail.com
J J
JJ
McInerney
J
J
Dias
S
S
Durham
A
A
Evans
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D010147:Pain Measurement; D016059:Range of Motion, Articular; D019534:Shoulder Impingement Syndrome / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D000070599:Shoulder Injuries; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D008775:Methylprednisolone