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Vol. 4. Issue 2.
Pages 49-54 (March - April 2008)
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Vol. 4. Issue 2.
Pages 49-54 (March - April 2008)
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Efficacy of the Local Injection of Methylprednisolone Acetate in the Subacromial Impingement Syndrome. A Randomized, Double-Blind Trial
Eficacia de la inyección local de acetato de metilprednisolona en el síndrome de pinzamiento subacromial. Un ensayo clínico aleatorizado, doble ciego
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José Álvarez-Nemegyeia,
Corresponding author
nemegyei@yahoo.com.mx

Correspondence: Calle 43 # 340 x 26-A Frac. Montealbán. C.P. 97114. Mérida. Yucatán. México.
, Alejandro Bassol-Pereab, José Rosado Pasosc
a Unidad de Investigación Médica, Unidad Médica de Alta Especialidad #25, Instituto Mexicano del Seguro Social, Mérida, Yucatán, Mexico
b Servicio de Ortopedia, Unidad Médica de Alta Especialidad #25, Instituto Mexicano del Seguro Social, Mérida, Yucatán, Mexico
c Unidad de Medicina Física y Rehabilitación, Unidad Médica de Alta Especialidad #25, Instituto Mexicano del Seguro Social, Mérida, Yucatán, Mexico
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Background

Local glucocorticosteroid injections are frequently used in the treatment of subacromial impingement syndrome (SIS), however its efficacy is still controversial.

Objective

To compare the efficacy of the subacromial injection of methylprenisolone acetate plus lidocaine (MPL) versus lidocaine alone (LA) in SIS.

Material and method

Consecutive SIS subjects, defined as a positive Neer's injection test were randomized to a subacromial injection of 2mL methylprednisolone acetate (40mg/mL) plus 1mL of 1% lidocaine (27 patients); or 3mL of 1% lidocaine (29 patients) were studied. The change from baseline of the score of a Spanish validated version of the Shoulder Disability Questionnaire (S-SDQ), pain intensity, and shoulder range of motion were measured at 15 and 30 days, and afterward every month for five months.

Results

After adjusting for duration of symptoms and pain intensity at baseline by way of a general lineal model, we did not find differences in the change of S-SDQ scores and shoulder range of motion between the study groups. Subjects randomized to LA had greater improvement of pain intensity than MPL subjects during the entire follow-up.

Conclusions

A subacromial injection of methylprednisolone acetate was not more efficacious than the injection of lydocaine alone in patients with SIS.

Key words:
Shoulder pain
Rotator cuff
Therapy
Clinical trial
Glucocorticosteroid injection
Antecedentes

Las inyecciones locales de glucocorticoides son frecuentemente utilizadas en el tratamiento del síndrome de pinzamiento subacromial (SPSA); sin embargo, su eficacia es aún motivo de controversia.

Objetivo

Comparar la eficacia de la inyección subacromial de metilprednisolona más lidocaína contra lidocaína sola en el tratamiento del SPSA.

Material y método

Se incluyó a pacientes con SPSA definido por un resultado positivo en la prueba de la inyección de Neer, quienes fueron aleatorizados para recibir una inyección de 2ml (40mg/ml) de acetato de metilprednisolona más 1ml de lidocaína al 1% (27 sujetos) o 3ml de lidocaína al 1% (29 sujetos). Se comparó el cambio desde la línea basal en la calificación de una versión validada al español del Shoulder Disability Questionnaire (S-SDQ) de la intensidad del dolor y de los arcos de movilidad a los 15 y 30 días, y luego cada mes por 5 meses más.

Resultados

El análisis mediante un modelo general lineal con ajuste para el tiempo de evolución y la intensidad del dolor en la línea basal no detectó diferencias en el cambio de la calificación S-SDQ y los arcos de movilidad entre los grupos de estudio en ningún momento del seguimiento. El grupo de lidocaína sola presentó mayor disminución en la intensidad del dolor durante todo el seguimiento.

Conclusiones

La inyección subacromial de acetato de metilprednisolona no fue más eficaz que la inyección de lidocaína sola en pacientes con SPSA.

Palabras clave:
Hombro doloroso
Manguito rotador
Tratamiento
Ensayo clínico
Inyección de glucocorticoide
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Copyright © 2008. Sociedad Española de Reumatología and Colegio Mexicano de Reumatología
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