Outcomes of ketorolac versus depomedrol infiltrations for subacromial impingement syndrome: a randomized controlled trial
Purpose Local subacromial infiltration with steroids is a common method of treatment of subacromial impingement syndrome. However, the use of steroids has concerns like tendon rupture, articular cartilage changes and infections. Local NSAIDs infiltration has recently been tried in literature. This s...
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| Veröffentlicht in: | Musculoskeletal surgery 2022-03, Vol.106 (1), p.29-34 |
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| creator | Goyal, T. Paul, S. Sethy, S. S. Choudhury, A. K. |
| description | Purpose
Local subacromial infiltration with steroids is a common method of treatment of subacromial impingement syndrome. However, the use of steroids has concerns like tendon rupture, articular cartilage changes and infections. Local NSAIDs infiltration has recently been tried in literature. This study compares the effect of subacromial injections of ketorolac with steroids.
Methods
A randomized controlled study was planned with 35 patients in each group. Patients in group-1 were infiltrated with subacromial ketorolac (60 mg with 2% lignocaine) and in group-2 with a steroid (methylprednisolone-40 mg with 2% lignocaine). A similar rehabilitation protocol was followed, and clinical outcomes were analyzed using visual analog scale (VAS) for pain and shoulder pain and disability score (SPADI) and range of motion at one-month and three-months follow-up.
Results
Total data of 67 patients were analyzed, as three patients were lost to follow-up. In group 1, mean VAS improved from 7.9
±
0.95 to 3.19
±
0.81 (
p
|
| doi_str_mv | 10.1007/s12306-020-00667-7 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2406310095</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A707083920</galeid><sourcerecordid>A707083920</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3577-3402652460406e319249310e41c9e18e31c9b7c563d2bcd9e252023c951c97b93</originalsourceid><addsrcrecordid>eNp9UdFqFTEQDaLY9uoP-CABX3zZOkk2yY1vpWgVCn3R55DNzpatu8k12RVuv96pt7YoIiFkmDnnMDmHsVcCTgWAfVeFVGAakNAAGGMb-4QdS1C60UK0Tx9qMEfspNYbArVb7Z6zIyXbVoO1x2x_tS4xz1h5Hvg3XHLJU4j8B5a6Vt7jjmY99fiYhnFaSljGnCofcuF17UIseR4DTefdmK5xxrTwuk_EmPE9D7yE1BPiFnsec1pIaKJyKcR5wZ4NYar48v7dsK8fP3w5_9RcXl18Pj-7bKLS1jaqBWm0bA20YFAJJ1unBGArokOxpU50nY3aqF52sXcotQSpotM0sJ1TG_b2oLsr-fuKdfHzWCNOU0iY1-ol6ZIgOE3QN39Bb_JaEm3npVGKLmjxiLoOE3ryJZMt8U7Un1mwsFWOjN-w03-g6PQ4j-QFkp34J0EeCORprQUHvyvjHMreC_B3eftD3p7y9r_y9pZIr-83XjsK6oHyO2ACqAOg0ogSKo9f-o_sT_titHs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2633263051</pqid></control><display><type>article</type><title>Outcomes of ketorolac versus depomedrol infiltrations for subacromial impingement syndrome: a randomized controlled trial</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Goyal, T. ; Paul, S. ; Sethy, S. S. ; Choudhury, A. K.</creator><creatorcontrib>Goyal, T. ; Paul, S. ; Sethy, S. S. ; Choudhury, A. K.</creatorcontrib><description>Purpose
Local subacromial infiltration with steroids is a common method of treatment of subacromial impingement syndrome. However, the use of steroids has concerns like tendon rupture, articular cartilage changes and infections. Local NSAIDs infiltration has recently been tried in literature. This study compares the effect of subacromial injections of ketorolac with steroids.
Methods
A randomized controlled study was planned with 35 patients in each group. Patients in group-1 were infiltrated with subacromial ketorolac (60 mg with 2% lignocaine) and in group-2 with a steroid (methylprednisolone-40 mg with 2% lignocaine). A similar rehabilitation protocol was followed, and clinical outcomes were analyzed using visual analog scale (VAS) for pain and shoulder pain and disability score (SPADI) and range of motion at one-month and three-months follow-up.
Results
Total data of 67 patients were analyzed, as three patients were lost to follow-up. In group 1, mean VAS improved from 7.9
±
0.95 to 3.19
±
0.81 (
p
< 0.001) and SPADI improved from 61.41
±
11.86 to 28.91
±
9.06 (
p
< 0.001) at three months, respectively. In group 2, mean VAS improved from 8.05
±
0.94 to 2.9
±
0.64 (
p
< 0.001) and SPADI improved from 63.45
±
9.64 to 25.32
±
6.87 (
p
< 0.001) at three months, respectively. However, there were no differences in functional outcomes between the groups (
p
= 0.21 for VAS,
p
= 0.16 for SPADI).
Conclusion
Subacromial ketorolac infiltration has an equivalent outcome as that of steroid infiltration. Ketorolac could be considered as a reasonable alternative to steroids in cases where it is contraindicated.</description><identifier>ISSN: 2035-5106</identifier><identifier>EISSN: 2035-5114</identifier><identifier>DOI: 10.1007/s12306-020-00667-7</identifier><identifier>PMID: 32445077</identifier><language>eng</language><publisher>Milan: Springer Milan</publisher><subject>Analysis ; Care and treatment ; Clinical outcomes ; Corticosteroids ; Humans ; Infection ; Ketorolac ; Ketorolac - therapeutic use ; Lidocaine ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Methylprednisolone ; Nonsteroidal anti-inflammatory drugs ; Original Article ; Orthopedics ; Pain management ; Patient outcomes ; Range of Motion, Articular ; Shoulder ; Shoulder Impingement Syndrome - drug therapy ; Shoulder Pain ; Steroids ; Surgical Orthopedics ; Treatment Outcome</subject><ispartof>Musculoskeletal surgery, 2022-03, Vol.106 (1), p.29-34</ispartof><rights>Istituto Ortopedico Rizzoli 2020</rights><rights>2020. Istituto Ortopedico Rizzoli.</rights><rights>COPYRIGHT 2022 Springer</rights><rights>Istituto Ortopedico Rizzoli 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3577-3402652460406e319249310e41c9e18e31c9b7c563d2bcd9e252023c951c97b93</citedby><cites>FETCH-LOGICAL-c3577-3402652460406e319249310e41c9e18e31c9b7c563d2bcd9e252023c951c97b93</cites><orcidid>0000-0002-8829-1206 ; 0000-0002-1172-3664 ; 0000-0002-4936-7896 ; 0000-0002-1428-9947</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12306-020-00667-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12306-020-00667-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27926,27927,41490,42559,51321</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32445077$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Goyal, T.</creatorcontrib><creatorcontrib>Paul, S.</creatorcontrib><creatorcontrib>Sethy, S. S.</creatorcontrib><creatorcontrib>Choudhury, A. K.</creatorcontrib><title>Outcomes of ketorolac versus depomedrol infiltrations for subacromial impingement syndrome: a randomized controlled trial</title><title>Musculoskeletal surgery</title><addtitle>Musculoskelet Surg</addtitle><addtitle>Musculoskelet Surg</addtitle><description>Purpose
Local subacromial infiltration with steroids is a common method of treatment of subacromial impingement syndrome. However, the use of steroids has concerns like tendon rupture, articular cartilage changes and infections. Local NSAIDs infiltration has recently been tried in literature. This study compares the effect of subacromial injections of ketorolac with steroids.
Methods
A randomized controlled study was planned with 35 patients in each group. Patients in group-1 were infiltrated with subacromial ketorolac (60 mg with 2% lignocaine) and in group-2 with a steroid (methylprednisolone-40 mg with 2% lignocaine). A similar rehabilitation protocol was followed, and clinical outcomes were analyzed using visual analog scale (VAS) for pain and shoulder pain and disability score (SPADI) and range of motion at one-month and three-months follow-up.
Results
Total data of 67 patients were analyzed, as three patients were lost to follow-up. In group 1, mean VAS improved from 7.9
±
0.95 to 3.19
±
0.81 (
p
< 0.001) and SPADI improved from 61.41
±
11.86 to 28.91
±
9.06 (
p
< 0.001) at three months, respectively. In group 2, mean VAS improved from 8.05
±
0.94 to 2.9
±
0.64 (
p
< 0.001) and SPADI improved from 63.45
±
9.64 to 25.32
±
6.87 (
p
< 0.001) at three months, respectively. However, there were no differences in functional outcomes between the groups (
p
= 0.21 for VAS,
p
= 0.16 for SPADI).
Conclusion
Subacromial ketorolac infiltration has an equivalent outcome as that of steroid infiltration. Ketorolac could be considered as a reasonable alternative to steroids in cases where it is contraindicated.</description><subject>Analysis</subject><subject>Care and treatment</subject><subject>Clinical outcomes</subject><subject>Corticosteroids</subject><subject>Humans</subject><subject>Infection</subject><subject>Ketorolac</subject><subject>Ketorolac - therapeutic use</subject><subject>Lidocaine</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Methylprednisolone</subject><subject>Nonsteroidal anti-inflammatory drugs</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Pain management</subject><subject>Patient outcomes</subject><subject>Range of Motion, Articular</subject><subject>Shoulder</subject><subject>Shoulder Impingement Syndrome - drug therapy</subject><subject>Shoulder Pain</subject><subject>Steroids</subject><subject>Surgical Orthopedics</subject><subject>Treatment Outcome</subject><issn>2035-5106</issn><issn>2035-5114</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UdFqFTEQDaLY9uoP-CABX3zZOkk2yY1vpWgVCn3R55DNzpatu8k12RVuv96pt7YoIiFkmDnnMDmHsVcCTgWAfVeFVGAakNAAGGMb-4QdS1C60UK0Tx9qMEfspNYbArVb7Z6zIyXbVoO1x2x_tS4xz1h5Hvg3XHLJU4j8B5a6Vt7jjmY99fiYhnFaSljGnCofcuF17UIseR4DTefdmK5xxrTwuk_EmPE9D7yE1BPiFnsec1pIaKJyKcR5wZ4NYar48v7dsK8fP3w5_9RcXl18Pj-7bKLS1jaqBWm0bA20YFAJJ1unBGArokOxpU50nY3aqF52sXcotQSpotM0sJ1TG_b2oLsr-fuKdfHzWCNOU0iY1-ol6ZIgOE3QN39Bb_JaEm3npVGKLmjxiLoOE3ryJZMt8U7Un1mwsFWOjN-w03-g6PQ4j-QFkp34J0EeCORprQUHvyvjHMreC_B3eftD3p7y9r_y9pZIr-83XjsK6oHyO2ACqAOg0ogSKo9f-o_sT_titHs</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Goyal, T.</creator><creator>Paul, S.</creator><creator>Sethy, S. S.</creator><creator>Choudhury, A. K.</creator><general>Springer Milan</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8829-1206</orcidid><orcidid>https://orcid.org/0000-0002-1172-3664</orcidid><orcidid>https://orcid.org/0000-0002-4936-7896</orcidid><orcidid>https://orcid.org/0000-0002-1428-9947</orcidid></search><sort><creationdate>20220301</creationdate><title>Outcomes of ketorolac versus depomedrol infiltrations for subacromial impingement syndrome: a randomized controlled trial</title><author>Goyal, T. ; Paul, S. ; Sethy, S. S. ; Choudhury, A. K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3577-3402652460406e319249310e41c9e18e31c9b7c563d2bcd9e252023c951c97b93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Analysis</topic><topic>Care and treatment</topic><topic>Clinical outcomes</topic><topic>Corticosteroids</topic><topic>Humans</topic><topic>Infection</topic><topic>Ketorolac</topic><topic>Ketorolac - therapeutic use</topic><topic>Lidocaine</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Methylprednisolone</topic><topic>Nonsteroidal anti-inflammatory drugs</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Pain management</topic><topic>Patient outcomes</topic><topic>Range of Motion, Articular</topic><topic>Shoulder</topic><topic>Shoulder Impingement Syndrome - drug therapy</topic><topic>Shoulder Pain</topic><topic>Steroids</topic><topic>Surgical Orthopedics</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Goyal, T.</creatorcontrib><creatorcontrib>Paul, S.</creatorcontrib><creatorcontrib>Sethy, S. S.</creatorcontrib><creatorcontrib>Choudhury, A. K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Musculoskeletal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Goyal, T.</au><au>Paul, S.</au><au>Sethy, S. S.</au><au>Choudhury, A. K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of ketorolac versus depomedrol infiltrations for subacromial impingement syndrome: a randomized controlled trial</atitle><jtitle>Musculoskeletal surgery</jtitle><stitle>Musculoskelet Surg</stitle><addtitle>Musculoskelet Surg</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>106</volume><issue>1</issue><spage>29</spage><epage>34</epage><pages>29-34</pages><issn>2035-5106</issn><eissn>2035-5114</eissn><abstract>Purpose
Local subacromial infiltration with steroids is a common method of treatment of subacromial impingement syndrome. However, the use of steroids has concerns like tendon rupture, articular cartilage changes and infections. Local NSAIDs infiltration has recently been tried in literature. This study compares the effect of subacromial injections of ketorolac with steroids.
Methods
A randomized controlled study was planned with 35 patients in each group. Patients in group-1 were infiltrated with subacromial ketorolac (60 mg with 2% lignocaine) and in group-2 with a steroid (methylprednisolone-40 mg with 2% lignocaine). A similar rehabilitation protocol was followed, and clinical outcomes were analyzed using visual analog scale (VAS) for pain and shoulder pain and disability score (SPADI) and range of motion at one-month and three-months follow-up.
Results
Total data of 67 patients were analyzed, as three patients were lost to follow-up. In group 1, mean VAS improved from 7.9
±
0.95 to 3.19
±
0.81 (
p
< 0.001) and SPADI improved from 61.41
±
11.86 to 28.91
±
9.06 (
p
< 0.001) at three months, respectively. In group 2, mean VAS improved from 8.05
±
0.94 to 2.9
±
0.64 (
p
< 0.001) and SPADI improved from 63.45
±
9.64 to 25.32
±
6.87 (
p
< 0.001) at three months, respectively. However, there were no differences in functional outcomes between the groups (
p
= 0.21 for VAS,
p
= 0.16 for SPADI).
Conclusion
Subacromial ketorolac infiltration has an equivalent outcome as that of steroid infiltration. Ketorolac could be considered as a reasonable alternative to steroids in cases where it is contraindicated.</abstract><cop>Milan</cop><pub>Springer Milan</pub><pmid>32445077</pmid><doi>10.1007/s12306-020-00667-7</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-8829-1206</orcidid><orcidid>https://orcid.org/0000-0002-1172-3664</orcidid><orcidid>https://orcid.org/0000-0002-4936-7896</orcidid><orcidid>https://orcid.org/0000-0002-1428-9947</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Musculoskeletal surgery, 2022-03, Vol.106 (1), p.29-34 |
| issn | 2035-5106 2035-5114 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Analysis Care and treatment Clinical outcomes Corticosteroids Humans Infection Ketorolac Ketorolac - therapeutic use Lidocaine Medical research Medicine Medicine & Public Health Medicine, Experimental Methylprednisolone Nonsteroidal anti-inflammatory drugs Original Article Orthopedics Pain management Patient outcomes Range of Motion, Articular Shoulder Shoulder Impingement Syndrome - drug therapy Shoulder Pain Steroids Surgical Orthopedics Treatment Outcome |
| title | Outcomes of ketorolac versus depomedrol infiltrations for subacromial impingement syndrome: a randomized controlled trial |
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