Injection of Sodium Hyaluronate versus Steroid Guided by Ultrasound in Management of Supraspinatus Tendinopathy

Abstract

Background: Rotator cuff (RC) tendinopathy is a common source of pain and shoulder dysfunction that affects both the young and older population. The available research findings emphasize the multifactorial origin of RC tendinopathy that begins as a failure in the tendon fibers due to the overuse and cyclic loading on their internal side Aim of the Work: To compare effect of injection of sodium hyaluronate versus steroid guided by ultrasound in treatment of rotator cuff tendinopathy. Patient and Methods: This study was conducted at the Department of Physical Medicine, Rheumatology and Rehabilitation at Ain Shams University Hospitals on 30 patients with shoulder pain. All patients were subjected to history taking, clinical examination and laboratory investigations together with diagnostic musculoskeletal ultrasound. We assessed by Pain and function scores using the visual analog scale (VAS), Oxford shoulder score (OSS), and Constant shoulder score (CSS). All patients were randomly assigned into one of two groups: Group I who received single steroid injection, Group II who received single hyaluronic acid injection. Patients were followed up after 2 months of injections. Results: Group I there were highly statistically significance differences between pre and post injection in Constant shoulder score, Oxford shoulder and VAS (i.e. improvement) (p < 0.01), Group II there were highly statistically significance differences between pre and post injection in Contestant shoulder score, Oxford shoulder and VAS (i.e. improvement) (p <0.01). On comparison between group I and group II post 2month injection. There were highly statistically significant differences (improvement) in group II versus group I as regarded Constant shoulder score and VAS (P <0.01). There were no statistically significant differences between two groups as regarded oxford shoulder score (p >0.05) Conclusion: Hyaluronic acid injection offers better therapeutic advantages over a corticosteroid injection in the treatment of rotator cuff tendinopathy especially in the intermediate-term follow up.