Clinical Effect of Steroid Administration in Patients with Chronic Impingement Syndrome on Postoperative Arthroscopic Subacromial Decompression

Year 2012, Volume: 17 Issue: 1, 32 - 35, 01.02.2012

Vahit Yıldız Ali Aydın Fatih Kalalı Ömer Selim Yıldırım Murat Topal Pelin Aydın

Abstract

Objective: We aimed in our study to investigate the effect of intraarticular corticosteroid injection applied to patients with the chronic impingement syndrome after arthroscopic subacromial decompression on the clinical result. Materials and Methods: We employed in our study a total of 44 (24 males, 20 females) patients with chronic impingement syndrome to whom intraarticular corticosteroid injection was applied before arthroscopic subacromial decompression between 1-7 times. We measured clinically Constant scores of those patients before and after arthroscopic subacromial decompression. We compared the correlation between the number of intraarticular corticosteroid injections and clinic scores and statistically the clinic results after and before arthroscopic subacromial decompression. Results: While the average Constant score of patients to whom intraarticular corticosteroid injection was applied 2.57 times on average is 15.27 (range 2-52), the average Constant score after arthroscopic subacromial decompression was 71.30 (range 2-90). The correlation was observed between the number of intraarticular corticosteroid injection and clinic results before arthroscopic subacromial decompression (P0.001). Conclusion: There is no correlation between the number of intraarticular corticosteroid injections applied to patients with chronic impingement syndrome and clinic results after arthroscopic subacromial decompression.

Keywords

-

Kronik İmpingement Sendromlu Hastalarda Uygulanan Steroidin Artroskopik Subakromiyal Dekompresyon Sonrasına Klinik Etkisi

Abstract

Amaç: Çalışmamızda Kronik impingement sendromlu hastalara uygulanan intraartiküler kortikostreoid enjeksiyonun, artroskopik subakromiyal dekompresyon sonrası klinik sonuca etkisini araştırmayı amaçladık. Gereç ve Yöntem: Artroskopik subakromiyal dekompresyon öncesi 1-7 defa arası intraartiküler kortikostreoid enjeksiyon uygulanan kronik impingement sendromlu toplam 44 (24 erkek, 20 kadın) hastayı çalışmamıza aldık. Artroskopik subakromial dekompresyon öncesi ve sonrası Constant skorlarını ölçerek istatiksel olarak karşılaştırdık. Bulgular: Ortalama 2.57 defa intraartiküler kortikostreoid enjeksiyonu uygulanan hastaların ortalama Constant skorunu 15.27 (dağılım 2-52), Artroskopik subakromiyal dekompresyon sonrasında ortalama Constant skorunu 71.30 (dağılım 2-90) ölçtük. İntraartiküler kortikostreoid enjeksiyon adedi ile artroskopik subakromiyal dekompresyon öncesi klinik sonuçlar arasında istatistiksel olarak anlamlı bir fark olmasına karşın (P0.001). Sonuç: Kronik impingement sendromlu hastalara uygulanan intraartiküler kortikostreoid enjeksiyonu adedi ile artroskopik subakromiyal dekompresyon sonrası klinik sonuçlar arasında bir ilişki bulunmamaktadır.

Keywords

Kronik impingement sendromu, Artroskopik subacromiyal dekompresyon, İntraartiküler kortikostreoid enjeksiyon

References

• 1. Matsen FA, Arntz CT. Subacromial Impingement. In: Rockwood CD Jr, Matsen FA (Editör). The Shoulder. 2nd ed. Philadelphia: W.B. Saunders, 1990: 623-645.
• 2. Neer CS. İmpingement lesions. Clin Orthop 1983; 173: 70-77. 3. Daigneault J, Cooney LM Jr. Shoulder pain in older people. J Am Geriatr Soc 1998; 46: 1144-1151.
• 4. Speed CA. Fortnightly review: Corticosteroid injections in tendon lesions. BMJ 2001; 323: 382-386.
• 5. Merdol F. Subakromiyal sıkışma sendromunun konservatif tedavisinde subakromiyal aralığa kortikosteroid enjeksiyonu ile ultrasonun etkinliğinin karşılaştırılması. Uzmanlık Tezi, İstanbul, 1999.
• 6. Ellman H. Arthroscopic subacromial decompression: analysis of one-to three-year results. Arthroscopy 1987; 3: 173-181.
• 7. Eustace JA, Brophy DP, Gibney RP, Bresnihan B, FitzGerald O. Comparison of the accuracy of steroid placement with clinical outcome in patients with shoulder symptoms. Ann Rheum Dis 1997; 56: 59-63.
• 8. Akgün K, Birtane M, Akarirmak U. Is local subacromial corticosteroid injection beneficial in subacromial impingement syndrome? Clin Rheumatol 2004; 23: 496-500.
• 9. Blair B, Rokito AS, Cuomo F, Jarolem K, Zuckerman JD. Efficacy of injections of corticosteroids for subacromial impingement syndrome. J Bone Joint Surg Am 1996; 78: 1685-1689.
• 10. Withrington RH, Girgis FL, Seifert MH. A placebo-controlled trial of steroid injections in the treatment of supraspinatus tendonitis. Scand J Rheumatol 1985; 14: 76-78.
• 11. Green S, Buchbinder R, Glazier R, Forbes A. Systematic review of randomised controlled trials of interventions for painful shoulder: selection criteria, outcome assessment, and efficacy. BMJ 1998; 316: 354-360.
• 12. Petri M, Dobrow R. Randomized, double-blind, placebocontrolled study of the treatment of the painful shoulder. Arthritis Rheum 1987; 30: 1040-1045.
• 13. Kayhan O, Anli S. Omuz periartritinde İ.A. glukokortikoid enjeksiyonu yöntemlerinin karşılaştırılması. Acta Orthop Traum Turc 1986; 20: 66-76.
• 14. McInerney JJ, Dias J, Durham S, Evans A. Randomized controlled trial of single, subacromial injection of methylprednizolone in patients with persistent, post-traumatic impingement of the shoulder. Energy Med J 2003; 20: 218- 221
• 15. Atalar AC, Demirhan M, Kocabey Y, Akalin Y. Artroskopik subakromiyal dekompresyon: 1-7 yıllık sonuçlar. Acta Orthop Traumatol Turc 2001; 35: 377-381.
• 16. Haahr JP, Ostergaard S, Dalsqaard J, Norup K, Frost P, Lausen S, et al. Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up. Ann Rheum Dis 2005; 64: 760-764.