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Erschienen in: Der Orthopäde 2/2017

28.07.2016 | Originalien

Lornoxicam injection is inferior to betamethasone in the treatment of subacromial impingement syndrome

A prospective randomized study of functional outcomes

verfasst von: M. Aksakal, C. Ermutlu, G. Özkaya, Y. Özkan

Erschienen in: Die Orthopädie | Ausgabe 2/2017

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Abstract

Background

Subacromial impingement syndrome (SIS) is one of the most frequent shoulder pathologies. Initial treatment is conservative. Subacromial injection of drugs achieves a high concentration at the pathologic site with less drug use and fewer systemic side effects. Glucocorticoids are most frequently injected. One concern with steroid use is the wide array of potential systemic and local complications. Nonsteroidal anti-inflammatory drugs (NSAIDs) are also peripherally acting and can be used locally. Although intraarticular (IA) use of NSAIDs is common in orthopedic practice, it is mostly restricted to the knee joint. Reports of local NSAID for joint pathologies are relatively rare. This study compared the efficacy of single-dose subacromial injections of betamethasone and lornoxicam for treatment of SIS.

Methods

Subacromial injections of either 7.0 mg betamethasone or 8 mg lornoxicam were received by 70 patients with mean age 53 (46–68) years. Treatment outcome was assessed with Constant–Murley and UCLA questionnaires before injection and at 2‑, 4‑, and 6‑week follow-ups.

Results

The change in outcome scores compared to pretreatment was higher in the steroid group at all follow-ups (p < 0.001). Patients in the steroid group showed a significant improvement at all follow-ups compared to pretreatment (p <0.001) and previous follow-ups (p <0.05) at all times. Patients in the lornoxicam group showed a significant functional improvement in week 2 (p <0.001), which was not evident in the following weeks (p >0.05). Although functional recovery halted after week 2, outcome scores remained significantly higher than the pretreatment values at all weeks (p <0.001).

Conclusion

Although a single subacromial lornoxicam injection provides rapid functional recovery, which partially extends into the intermediate term, its results are inferior to betamethasone and it may be an alternative only in patients where corticosteroids are contraindicated.
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Metadaten
Titel
Lornoxicam injection is inferior to betamethasone in the treatment of subacromial impingement syndrome
A prospective randomized study of functional outcomes
verfasst von
M. Aksakal
C. Ermutlu
G. Özkaya
Y. Özkan
Publikationsdatum
28.07.2016
Verlag
Springer Medizin
Erschienen in
Die Orthopädie / Ausgabe 2/2017
Print ISSN: 2731-7145
Elektronische ISSN: 2731-7153
DOI
https://doi.org/10.1007/s00132-016-3302-5

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