Clinical Function Improves After Subacromial Injection of Local Anesthetic in Full-Thickness Rotator Cuff Tears: A Randomized Control Trial.

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ID: 80624
2020
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Abstract
Rotator cuff pathology is the most common cause of shoulder pain in adults, accounting for nearly 70% of shoulder-related visits to clinicians. However, physical examination findings may be limited because of pain or patient inhibition.To establish whether a relationship exists between pain, range of motion, and strength in patients with a full-thickness rotator cuff tear.Randomized controlled trial; Level of evidence, 1.A single-blind, randomized controlled study of 40 patients undergoing rotator cuff repair for full-thickness rotator cuff tears was performed. Patients were randomized to receive either a subacromial 10-mL 2% lidocaine injection or a sham injection, with no contents being injected into the subacromial space. Before the injection, patients were assessed using a visual analog scale for pain (VAS-Pain) as well as the Constant-Murley subjective questionnaire and objective physical examination. The examination was repeated 10 minutes after injection and 6 months postoperatively. VAS-Pain after injection was not assessed. The assessment at 6 months was performed to demonstrate improvement of rotator cuff function after operative management. Statistical analysis included Student and chi-square tests as well as multivariate binomial logistic regression analyses to identify predictors for improvement after injection. Results were considered significant if < .05.Range of motion, strength, and Constant-Murley score significantly improved after a subacromial lidocaine injection ( .05). Range of motion, strength, Constant-Murley score, and VAS-Pain significantly improved at final follow-up compared with the preinjection assessment for both groups ( .05); however, there was no difference ( .05) between groups at 6 months postoperatively.After subacromial lidocaine injections, patients exhibited modest but significant improvements in range of motion, strength, and the Constant-Murley score. Pain may limit range of motion and strength in patients with full-thickness rotator cuff tears independent of the mechanical impact of the tear itself.NCT02693444 (ClinicalTrials.gov identifier).
Reference Key
forsythe2020clinicalorthopaedic Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Forsythe, Brian;Agarwalla, Avinesh;Puzzitiello, Richard N;Patel, Bhavik H;Lu, Yining;Verma, Nikhil N;Romeo, Anthony A;Cole, Brian J;
Journal Orthopaedic journal of sports medicine
Year 2020
DOI
10.1177/2325967119892331
URL
Keywords
shoulder rotator cuff tears constant-murley subacromial injection

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