Table 1.
Characteristics of reviewed clinical trials on efficacy of corticosteroid injection for rotator cuff tendinosis
| Studies | Year | Country | Number of patients in control group | Number of patients in treatment group | Percent male in study | Mean age (years) | Placebo type | Intervention | Injection approach and guidance |
|---|---|---|---|---|---|---|---|---|---|
| Richardson [47] | 1975 | UK | 47 | 45 | 52 | NR | Normal saline | Methylprednisolone, 25 mg, repeated injection at 2 weeks | Posterior approach, palpation |
| Withrington et al. [52] | 1985 | UK | 13 | 12 | 24 | 58 | Normal saline | Methylprednisolone, 80 mg, single injection | Lateral approach, palpation |
| Petri et al. [46] | 1987 | USA | 25 | 25 | 69 | NR | Lidocaine | Triamcinolone, 40 mg, single injection | Lateral approach, palpation |
| Adebajo et al. [1] | 1990 | UK | 20 | 20 | 57 | 53 | Lignocaine | Triamcinolone, 80 mg, single injection | Lateral approach, palpation |
| Vecchio et al. [51] | 1993 | UK | 27 | 28 | 42 | 56 | Lignocaine | Methylprednisolone, 40 mg, single injection | Lateral approach, palpation |
| Blair et al. [8] | 1996 | USA | 21 | 19 | 20 | 56 | Lidocaine | Triamcinolone, 80 mg, single injection | Lateral approach, palpation |
| McInerney et al. [38] | 2003 | Ireland | 44 | 54 | 65 | 48 | Bupivacaine | Methylprednisolone, 40 mg, single injection | Posterior approach, palpation |
| Akgun et al. [2] | 2004 | Turkey | 16 | 16 | 31 | 49 | Lignocaine | Methylprednisolone, 40 mg, either single injection or repeated injection after 10 days | Anterior approach, palpation |
| Alvarez et al. [3] | 2005 | Canada | 28 | 30 | 53 | 55 | Xylocaine | Betamethasone, 6 mg, single injection | Anterior approach palpation |
| Alvarez-Nemegyei et al. [4] | 2008 | Mexico | 29 | 27 | 23 | 53 | Lidocaine | Methylprednisolone, 40 mg, single injection | Lateral approach, palpation |
| Hong et al. [32] | 2011 | South Korea | 27 | 27 | 41 | 50 | Lidocaine | Triamcinolone, 40 mg or 20 mg, single injection† | Posterior approach, ultrasound-guided |
| Penning et al. [44] | 2012 | Netherlands | 53 | 52 | 47 | 53 | Lidocaine | Triamcinolone, 20 mg, repeated injection after 3 and 6 weeks | Palpation, dorsolateral approach |
| Penning et al. [45] | 2014 | Netherlands | 55 | 51 | 47 | 53 | Lidocaine | Triamcinolone, 20 mg, repeated injection after 3 and 6 weeks | Palpation, dorsolateral approach |
| Lin et al. [37] | 2015 | Taiwan | 23 | 44 | 33 | 58 | Xylocaine | Triamcinolone, 10 mg, single injection | NR, ultrasound-guided |
| Studies | Year | Country | Diagnostic criteria | Outcome | Assessment 1 | Assessment 2 | Assessment 3 | Assessment 4 | Jadadscore |
|---|---|---|---|---|---|---|---|---|---|
| Richardson [47] | 1975 | UK | Shoulder pain exacerbated by resisted movement, and/or loss of passive range of movement | Percent of patients who have definite improvement in or complete resolution of pain (scale of 1–5) | 0 | 0 | N/A | N/A | 3 |
| Withrington et al. [52] | 1985 | UK | Shoulder pain exacerbated by resisted movement, normal passive glenohumeral range of movement | VAS 0–10 scale | 0 | N/A | 0 | N/A | 2 |
| Petri et al. [46] | 1987 | USA | Presence of at least 2 of the following 3 findings: painful abduction at any degree of motion, painful arc of movement from 45o to 120°, or tenderness over the insertion of the supraspinatus tendon | Pain (0–5) 0 worst | 1 | 1 | N/A | N/A | 5 |
| Adebajo et al. [1] | 1990 | UK | Shoulder pain exacerbated by resisted movement, normal passive glenohumeral range of movement | VAS 0–10 scale | N/A | 1 | N/A | N/A | 4 |
| Vecchio et al. [51] | 1993 | UK | Shoulder pain exacerbated by resisted movement, normal passive glenohumeral range of movement | 3 *VAS 0–10 scale (pain at rest, at night and in movement) scale of 0–30 | 0 | 0 | 0 | N/A | 3 |
| Blair et al. [8] | 1996 | USA | Shoulder impingement syndrome based on the lidocaine injection test and positive Neer test [41] | 4-point self-administered pain score (0 indicates no pain, 4 indicates severe pain) | N/A | N/A | N/A | 1 | 2 |
| McInerney et al. [38] | 2003 | Ireland | Shoulder pain exacerbated by resisted movement, normal passive glenohumeral range of movement, positive Neer test [41] | VAS 0–10 scale | 0 | 0 | 0 | N/A | 4 |
| Akgun et al. [2] | 2004 | Turkey | Subacromial impingement syndrome, positive Neer [41] and Hawkins [28] tests, indicative MRI findings | VAS 0–10 scale | N/A | 1 | 0 | N/A | 3 |
| Alvarez et al. [3] | 2005 | Canada | Shoulder pain exacerbated by resisted movement, normal passive glenohumeral range of movement, positive Neer test [41] | VAS 0–100 scale for Neer impingement sign | 0 | 0 | 0 | 0 | 5 |
| Alvarez-Nemegyei et al. [4] | 2008 | Mexico | Tendinitis and subacromial impingement syndrome based on the criteria of the Southampton group [43] and positive Neer test [41] | VAS 0–100 scale | 1 | 1 | 1 | 1 | 5 |
| Hong et al. [32] | 2011 | South Korea | Shoulder Impingement syndrome, positive Neer [41] and Hawkins [28] tests | VAS 0–10 scale | 1 | 1 | 1 | N/A | 5 |
| Penning et al. [44] | 2012 | Netherlands | Clinical diagnosis of shoulder impingement syndrome | VAS 0–10 scale | 0 | 1 | 0 | 0 | 5 |
| Penning et al. [45] | 2014 | Netherlands | Clinical diagnosis of shoulder impingement syndrome | VAS 0–10 scale | 1 | 1 | 1 | N/A | 5 |
| Lin et al. [37] | 2015 | Taiwan | Chronic shoulder pain (for > 6 months) with calcifications in the rotator cuff with confirmation by gray-scale ultrasound image | VAS 0–10 scale | N/A | N/A | 0 | N/A | 0 |
Assessment 1 = less than 4 weeks; Assessment 2 = from 4 to 8 weeks; Assessment 3 = 8-including 12 weeks; Assessment 4 = more than 12 weeks; *0 = not significant, 1= significant; †40-mg dose was used for meta-analysis; NR = not reported; N/A = not assessed.