Abstract
Objectives
The study aimed to investigate whether the shoulder tendons changed their elasticity
after ultrasound-guided peritendinous or intrabursal corticosteroid injections.
Design
Post hoc secondary analysis of a double-blinded, randomized controlled study with
3 months of follow-up.
Setting
Outpatient rehabilitation clinic.
Participants
Patients with subacromial impingement syndrome (N=60).
Interventions
Patients with unilateral shoulder pain were randomly assigned to receive standard
ultrasound-guided subacromial or dual-target corticosteroid injections. The supraspinatus
tendons were exposed to 40 mg triamcinolone acetonide in the formal group, whereas
the long head of the biceps brachii tendons (LHBT) and supraspinatus tendons were
individually infiltrated by 20 mg triamcinolone acetonide in the latter group. Patients’
bilateral shoulders were divided into group 1 (n=30, receiving standard subacromial
injections), group 2 (n=30, receiving dual-target injections), and group 3 (n=60,
without injections).
Main Outcome Measures
Strain ratio of LHBT and supraspinatus tendons using ultrasound elastography.
Results
The repeated-measures analysis of variance revealed no intragroup difference of the
strain ratio of the LHBT (P=.412 for group 1, P=.936 for group 2, P=.131 for group 3) and supraspinatus tendon (P=.309 for group 1, P=.067 for group 2, P=.860 for group 3) across the 3 time points. Treating group 3 as the reference, the
linear mixed model revealed no significant changes in tendon elasticity after either
the standard subacromial injection (P=.205 for the LHBT and P=.529 for the supraspinatus tendon) or the dual-target injection (P=.961 for the LHBT and P=.831 for the supraspinatus tendon).
Conclusions
Elasticity of the LHBT and supraspinatus tendons is unlikely to change after a single
dose of peritendinous or intrabursal corticosteroid injections. Future studies with
a shorter follow-up interval are needed to validate whether corticosteroid injections
can cause transient changes of the tendon’s elasticity.
Keywords
List of abbreviations:
ANOVA (analysis of variance), LHBT (long head of the biceps brachii tendons), ROI (region of interest), US (ultrasound)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 15, 2020
Footnotes
Supported by National Taiwan University Hospital, Bei-Hu Branch, Ministry of Science and Technology (grant nos. 106-2314-B-002-180-MY3,109-2314-B-002-114-MY3 and 109-2314-B-002-127), and Taiwan Society of Ultrasound in Medicine.
Clinical Trial Registration No.: NCT03148353.
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
