The Effect of Paratendinous Aprotinin Injection in Patients with Rotator Cuff Tendinitis

ABSTRACT

OBJECTIVE: To determine the therapeutic effect of paratendinous injection of aprotinin, a polyvalent inhibitor of inflammatory proteolytic enzyme, in patients with shoulder tendinitis. METHOD: Thirty patients with shoulder tendinitis diagnosed with ultrasonography were included. Patients were assigned to one of two groups at random to receive paratendinous injection. One group received a paratendinous aprotinin 1.5 ml and 1% lidocaine 2 ml injection of shoulder2~5 times at 1 week apart. The other group received a paratendinous injection one time with mixture of triamcinolone 40 mg and 1% lidocaine 2.5 ml. The effect of treatment was assessed with the visual analogue scale (VAS), and the patients' life activities were assessed with the Western Ontario rotator cuff(WORC) index. RESULTS: The VAS of the two groups showed improvement at 1 week (aprotinin group 2.9+/-0.7, triamcinolone group 3.7+/-1.2) and 4 weeks (aprotinin group 2.1+/-1.0, triamcinolone group 2.4+/-1.0) after injection compared with pre- injection status (aprotinin group 8.6+/-1.3, triamcinolone group 8.2+/-1.3)(p<0.01) and the WORC index of the two groups showed improvement at 1 week (aprotinin group 36.5+/-7.8, triamcinolone group 53.2+/-12.3) and 4 weeks (aprotinin group 33.4+/-6.2, triamcinolone group 31.4+/-8.8) after injection compared with pre-injection status (aprotinin group 116.2+/-29.1, triamcinolone group 123.5+/-37.0)(p< 0.01). There was no significant difference in the improvement of the VAS scores and WORC index between the two groups. CONCLUSION: The short term effect of paratendinous aprotinin injection in patients with shoulder tendinitis was as good as triamcinolone injection, although more frequent injection was necessary.