| Methods |
Randomised controlled trial
Blinding: both participants and outcome assessors were blinded.
Loss to follow up: not reported but treatment in in Group 1 discontinued after interim analysis of first 10 patients found lack of efficacy in all patients and pain aggravation in 4 patients.
Appropriate statistical analysis: yes, intention to treat. |
| Participants |
50 patients:
Inclusion criteria: painful disabling impingement syndrome for at least 3 months duration. Diagnosis based on patient's history and positive impingement signs according to Neer and Hawkins.
Exclusion criteria: concomitant cervical cervical radiculopathy, prior subacromial corticosteroid injection, adhesive capsulitis, full or partial‐thickness rotator cuff tears, calcifying tendinitis, disorders of acromioclavicular joint, shoulder instability, involvement in workers compensation claims. |
| Interventions |
Group 1(10 patients): 10ml injection of pure 0.5% bupivacaine
Group 2(20 patients): 10mg injection of triamcinolone acetonide (crystalline corticosteroid) with 10ml 0.5% bupivacaine
Group 3(20 patients): 4mg injection dexamethasone‐21‐palmitat (lipoid corticosteroid, equivalent to 2.5mg dexamethasone) with 10 ml of 0.5% bupivacaine. All injections were into subacromial bursae with positioning verified by ultrasound. All patients received standardized physiotherapy program consisting of cryotherapy and active strengthening o the rotator cuff muscles. |
| Outcomes |
Assessed at baseline, 1, 6 and 26 weeks
1) impingement signs
2) pain scale
3) Patte score ‐ judges subjective estimation of pain, function, force and overall handicap (excellent when score > 85%)
4) Ultrasound examination |
| Notes |
No data presented that could be used for meta‐analysis.
Reported that 'favourable' results were achieved in 19 out of 40 participants who received steroid injection. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment? |
Unclear risk |
B ‐ Unclear |
