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
José Álvarez-Nemegyeia,
, Alejandro Bassol-Pereab, José Rosado Pasosc
Corresponding author
nemegyei@yahoo.com.mx
Correspondence: Calle 43 # 340 x 26-A Frac. Montealbán. C.P. 97114. Mérida. Yucatán. México.
Correspondence: Calle 43 # 340 x 26-A Frac. Montealbán. C.P. 97114. Mérida. Yucatán. México.
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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A Randomized, Double-Blind Trial" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "49" "paginaFinal" => "54" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José Álvarez-Nemegyei, Alejandro Bassol-Perea, José Rosado Pasos" "autores" => array:3 [ 0 => array:4 [ "nombre" => "José" "apellidos" => "Álvarez-Nemegyei" "email" => array:1 [ 0 => "nemegyei@yahoo.com.mx" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Alejandro" "apellidos" => "Bassol-Perea" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "José" "apellidos" => "Rosado Pasos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Unidad de Investigación Médica, Unidad Médica de Alta Especialidad #25, Instituto Mexicano del Seguro Social, Mérida, Yucatán, Mexico" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Ortopedia, Unidad Médica de Alta Especialidad #25, Instituto Mexicano del Seguro Social, Mérida, Yucatán, Mexico" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad de Medicina Física y Rehabilitación, Unidad Médica de Alta Especialidad #25, Instituto Mexicano del Seguro Social, Mérida, Yucatán, Mexico" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondence: Calle 43 # 340 x 26-A Frac. Montealbán. C.P. 97114. Mérida. Yucatán. México." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Eficacia de la inyección local de acetato de metilprednisolona en el síndrome de pinzamiento subacromial. Un ensayo clínico aleatorizado, doble ciego" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-08-20" "fechaAceptado" => "2007-11-29" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec111745" "palabras" => array:5 [ 0 => "Shoulder pain" 1 => "Rotator cuff" 2 => "Therapy" 3 => "Clinical trial" 4 => "Glucocorticosteroid injection" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec111746" "palabras" => array:5 [ 0 => "Hombro doloroso" 1 => "Manguito rotador" 2 => "Tratamiento" 3 => "Ensayo clínico" 4 => "Inyección de glucocorticoide" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Local glucocorticosteroid injections are frequently used in the treatment of subacromial impingement syndrome (SIS), however its efficacy is still controversial.</p> <span class="elsevierStyleSectionTitle">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To compare the efficacy of the subacromial injection of methylprenisolone acetate plus lidocaine (MPL) versus lidocaine alone (LA) in SIS.</p> <span class="elsevierStyleSectionTitle">Material and method</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Consecutive SIS subjects, defined as a positive Neer's injection test were randomized to a subacromial injection of 2<span class="elsevierStyleHsp" style=""></span>mL methylprednisolone acetate (40<span class="elsevierStyleHsp" style=""></span>mg/mL) plus 1<span class="elsevierStyleHsp" style=""></span>mL of 1% lidocaine (27 patients); or 3<span class="elsevierStyleHsp" style=""></span>mL 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.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A subacromial injection of methylprednisolone acetate was not more efficacious than the injection of lydocaine alone in patients with SIS.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Antecedentes</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Comparar la eficacia de la inyección subacromial de metilprednisolona más lidocaína contra lidocaína sola en el tratamiento del SPSA.</p> <span class="elsevierStyleSectionTitle">Material y método</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">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 2<span class="elsevierStyleHsp" style=""></span>ml (40<span class="elsevierStyleHsp" style=""></span>mg/ml) de acetato de metilprednisolona más 1<span class="elsevierStyleHsp" style=""></span>ml de lidocaína al 1% (27 sujetos) o 3<span class="elsevierStyleHsp" style=""></span>ml 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.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La inyección subacromial de acetato de metilprednisolona no fue más eficaz que la inyección de lidocaína sola en pacientes con SPSA.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of shoulder pain in the community: the influence of case definition" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.P. Pope" 1 => "P.R. Croft" 2 => "C.M. Pritchard" 3 => "A.J. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 16 | 23 |
| 2024 October | 28 | 24 | 52 |
| 2024 September | 43 | 17 | 60 |
| 2024 August | 45 | 41 | 86 |
| 2024 July | 27 | 43 | 70 |
| 2024 June | 35 | 37 | 72 |
| 2024 May | 36 | 30 | 66 |
| 2024 April | 40 | 25 | 65 |
| 2024 March | 36 | 37 | 73 |
| 2024 February | 29 | 25 | 54 |
| 2024 January | 20 | 21 | 41 |
| 2023 December | 34 | 35 | 69 |
| 2023 November | 35 | 28 | 63 |
| 2023 October | 22 | 30 | 52 |
| 2023 September | 38 | 42 | 80 |
| 2023 August | 17 | 10 | 27 |
| 2023 July | 18 | 24 | 42 |
| 2023 June | 18 | 21 | 39 |
| 2023 May | 14 | 8 | 22 |
| 2023 April | 12 | 6 | 18 |
| 2023 March | 32 | 30 | 62 |
| 2023 February | 22 | 29 | 51 |
| 2023 January | 13 | 25 | 38 |
| 2022 December | 36 | 31 | 67 |
| 2022 November | 37 | 25 | 62 |
| 2022 October | 32 | 30 | 62 |
| 2022 September | 23 | 36 | 59 |
| 2022 August | 30 | 51 | 81 |
| 2022 July | 28 | 48 | 76 |
| 2022 June | 27 | 34 | 61 |
| 2022 May | 21 | 45 | 66 |
| 2022 April | 48 | 46 | 94 |
| 2022 March | 43 | 49 | 92 |
| 2022 February | 40 | 33 | 73 |
| 2022 January | 27 | 33 | 60 |
| 2021 December | 28 | 41 | 69 |
| 2021 November | 19 | 49 | 68 |
| 2021 October | 35 | 68 | 103 |
| 2021 September | 21 | 53 | 74 |
| 2021 August | 27 | 49 | 76 |
| 2021 July | 21 | 60 | 81 |
| 2021 June | 35 | 59 | 94 |
| 2021 May | 46 | 63 | 109 |
| 2021 April | 119 | 76 | 195 |
| 2021 March | 59 | 40 | 99 |
| 2021 February | 55 | 31 | 86 |
| 2021 January | 20 | 27 | 47 |
| 2020 December | 18 | 29 | 47 |
| 2020 November | 28 | 27 | 55 |
| 2020 October | 10 | 14 | 24 |
| 2020 September | 23 | 26 | 49 |
| 2020 August | 18 | 21 | 39 |
| 2020 July | 11 | 23 | 34 |
| 2020 June | 26 | 20 | 46 |
| 2020 May | 31 | 16 | 47 |
| 2020 April | 24 | 18 | 42 |
| 2020 March | 15 | 6 | 21 |
| 2020 January | 10 | 0 | 10 |
| 2019 September | 4 | 0 | 4 |
| 2019 June | 2 | 0 | 2 |
| 2019 March | 2 | 0 | 2 |
| 2019 February | 2 | 0 | 2 |
| 2019 January | 2 | 0 | 2 |
| 2018 May | 3 | 1 | 4 |
| 2018 April | 14 | 14 | 28 |
| 2018 March | 11 | 10 | 21 |
| 2018 February | 15 | 5 | 20 |
| 2018 January | 10 | 5 | 15 |
| 2017 December | 10 | 7 | 17 |
| 2017 November | 12 | 9 | 21 |
| 2017 October | 7 | 5 | 12 |
| 2017 September | 11 | 9 | 20 |
| 2017 August | 12 | 5 | 17 |
| 2017 July | 12 | 4 | 16 |
| 2017 June | 22 | 20 | 42 |
| 2017 May | 30 | 10 | 40 |
| 2017 April | 18 | 2 | 20 |
| 2017 March | 17 | 11 | 28 |
| 2017 February | 9 | 4 | 13 |
| 2017 January | 18 | 7 | 25 |
| 2016 December | 41 | 14 | 55 |
| 2016 November | 25 | 3 | 28 |
| 2016 October | 36 | 6 | 42 |
| 2016 September | 27 | 4 | 31 |
| 2016 August | 19 | 7 | 26 |
| 2016 July | 13 | 9 | 22 |
| 2016 May | 1 | 0 | 1 |
| 2016 April | 1 | 0 | 1 |
| 2016 February | 3 | 0 | 3 |
| 2016 January | 1 | 0 | 1 |
| 2015 December | 4 | 0 | 4 |
| 2015 September | 1 | 0 | 1 |
| 2015 August | 1 | 0 | 1 |
| 2015 July | 9 | 5 | 14 |
| 2015 June | 16 | 13 | 29 |
| 2015 May | 29 | 22 | 51 |
| 2015 April | 13 | 15 | 28 |
| 2015 March | 17 | 12 | 29 |
| 2015 February | 19 | 22 | 41 |
| 2015 January | 10 | 20 | 30 |
| 2014 December | 17 | 19 | 36 |
| 2014 November | 15 | 15 | 30 |
| 2014 October | 10 | 18 | 28 |
| 2014 September | 12 | 10 | 22 |
| 2014 August | 17 | 19 | 36 |
| 2014 July | 12 | 16 | 28 |
| 2014 June | 30 | 16 | 46 |
| 2014 May | 30 | 23 | 53 |
| 2014 April | 24 | 13 | 37 |
| 2014 March | 37 | 15 | 52 |
| 2014 February | 25 | 25 | 50 |
| 2014 January | 26 | 15 | 41 |
| 2013 December | 22 | 19 | 41 |
| 2013 November | 18 | 12 | 30 |
| 2013 October | 29 | 16 | 45 |
| 2013 September | 35 | 12 | 47 |
| 2013 August | 16 | 7 | 23 |
| 2013 July | 21 | 11 | 32 |
| 2013 June | 17 | 11 | 28 |
| 2013 May | 24 | 10 | 34 |
| 2013 April | 28 | 11 | 39 |
| 2013 March | 19 | 8 | 27 |
| 2013 February | 18 | 6 | 24 |
| 2013 January | 22 | 9 | 31 |
| 2012 December | 11 | 10 | 21 |
| 2012 November | 7 | 9 | 16 |
| 2012 October | 4 | 8 | 12 |
| 2012 September | 6 | 3 | 9 |
| 2012 June | 2 | 0 | 2 |
| 2012 April | 4 | 0 | 4 |
| 2012 March | 4 | 0 | 4 |
| 2012 January | 4 | 0 | 4 |
| 2011 December | 4 | 0 | 4 |
| 2011 November | 4 | 0 | 4 |
| 2011 October | 4 | 0 | 4 |
| 2011 September | 1 | 0 | 1 |
| 2011 August | 1 | 0 | 1 |
| 2011 June | 2 | 0 | 2 |
| 2011 May | 4 | 0 | 4 |
| 2011 March | 5 | 0 | 5 |
| 2011 February | 7 | 0 | 7 |
| 2011 January | 7 | 0 | 7 |
| 2010 December | 16 | 0 | 16 |
| 2010 November | 8 | 0 | 8 |
| 2010 October | 11 | 0 | 11 |
| 2010 September | 2 | 0 | 2 |
| 2010 August | 6 | 0 | 6 |
| 2010 July | 4 | 0 | 4 |
| 2010 June | 3 | 0 | 3 |
| 2010 May | 5 | 0 | 5 |
| 2010 April | 6 | 0 | 6 |
| 2010 March | 4 | 0 | 4 |
| 2010 February | 2 | 0 | 2 |
| 2010 January | 7 | 0 | 7 |
| 2009 December | 5 | 0 | 5 |
| 2009 November | 5 | 0 | 5 |
| 2009 October | 6 | 0 | 6 |
| 2009 September | 6 | 0 | 6 |
| 2009 August | 7 | 0 | 7 |
| 2009 July | 6 | 0 | 6 |
| 2009 June | 10 | 0 | 10 |
| 2009 May | 8 | 0 | 8 |
| 2009 April | 10 | 0 | 10 |
| 2009 March | 9 | 0 | 9 |
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