Eficacia de la inyección local de acetato de metilprednisolona en el síndrome de pinzamiento subacromial. Un ensayo clínico aleatorizado, doble ciego / Efficacy of the local injection of methylprednisolone acetate in the subacromial impingement syndrome. A randomized, double-blind trial

Antecedentes: Las inyecciones locales de glucocorticoides son frecuentemente utilizadas en el tratamiento del síndrome de pinzamiento subacromial (SPSA); sin embargo, su eficacia es aún motivo de controversia. Objetivo: Comparar la eficacia de la inyección subacromial de metilprednisolona más lidocaína contra lidocaína sola en el tratamiento del SPSA. Material y método: Se incluyó a pacientes con SPSA definido por un resultado positivo en la prueba de la inyección de Neer, quienes fueron aleatorizados para recibir una inyección de 2 ml (40 mg/ml) de acetato de metilprednisolona más 1 ml de lidocaína al 1% (27 sujetos) o 3 ml de lidocaína al 1% (29 sujetos). Se comparó el cambio desde la línea basal en la calificación de una versión validada al español del Shoulder Disability Questionnaire (S-SDQ) de la intensidad del dolor y de los arcos de movilidad a los 15 y 30 días, y luego cada mes por 5 meses más. Resultados: El análisis mediante un modelo general lineal con ajuste para el tiempo de evolución y la intensidad del dolor en la línea basal no detectó diferencias en el cambio de la calificación S-SDQ y los arcos de movilidad entre los grupos de estudio en ningún momento del seguimiento. El grupo de lidocaína sola presentó mayor disminución en la intensidad del dolor durante todo el seguimiento. Conclusiones: La inyección subacromial de acetato de metilprednisolona no fue más eficaz que la inyección de lidocaína sola en pacientes con SPSA (AU)

Background: Local glucocorticosteroid injections are frequently used in the treatment of subacromial impingement syndrome (SIS), however its efficacy is still controversial. Objective: To compare the efficacy of the subacromial injection of methylprenisolone acetate plus lidocaine (MPL) versus lidocaine alone (LA) in SIS. Material and method: Consecutive SIS subjects, defined as a positive Neer’s injection test were randomized to a subacromial injection of 2 mL methylprednisolone acetate (40 mg/mL) plus 1 mL of 1% lidocaine (27 patients); or 3 mL of 1% lidocaine (29 patients) were studied. The change from baseline of the score of a Spanish validated version of the Shoulder Disability Questionnaire (S-SDQ), pain intensity, and shoulder range of motion were measured at 15 and 30 days, and afterward every month for five months. Results: After adjusting for duration of symptoms and pain intensity at baseline by way of a general lineal model, we did not find differences in the change of S-SDQ scores and shoulder range of motion between the study groups. Subjects randomized to LA had greater improvement of pain intensity than MPL subjects during the entire follow-up. Conclusions: A subacromial injection of methylprednisolone acetate was not more efficacious than the injection of lydocaine alone in patients with SIS (AU)

[Efficacy of the local injection of methylprednisolone acetate in the subacromial impingement syndrome. A randomized, double-blind trial]. / Eficacia de la inyección local de acetato de metilprednisolona en el síndrome de pinzamiento subacromial. Un ensayo clínico aleatorizado, doble ciego.

BACKGROUND: Local glucocorticosteroid injections are frequently used in the treatment of subacromial impingement syndrome (SIS), however its efficacy is still controversial. OBJECTIVE: To compare the efficacy of the subacromial injection of methylprenisolone acetate plus lidocaine (MPL) versus lidocaine alone (LA) in SIS. MATERIAL AND METHOD: Consecutive SIS subjects, defined as a positive Neer's injection test were randomized to a subacromial injection of 2 mL methylprednisolone acetate (40 mg/mL) plus 1 mL of 1% lidocaine (27 patients); or 3 mL of 1% lidocaine (29 patients) were studied. The change from baseline of the score of a Spanish validated version of the Shoulder Disability Questionnaire (S-SDQ), pain intensity, and shoulder range of motion were measured at 15 and 30 days, and afterward every month for five months. RESULTS: After adjusting for duration of symptoms and pain intensity at baseline by way of a general lineal model,we did not find differences in the change of S-SDQ scores and shoulder range of motion between the study groups. Subjects randomized to LA had greater improvement of pain intensity than MPL subjects during the entire follow-up. CONCLUSIONS: A subacromial injection of methylprednisolone acetate was not more efficacious than the injection of lydocaine alone in patients with SIS.