In cases without complete tears, FIVE weeks of weekly subacromial injections of Hyaluronate was helpful.
- cases – shoulder pain, a positive impingement sign, and a positive imaging diagnosis of rotator cuff pathology without a complete tear. 18 articular-side tears, 5 bursal-side tears, and 31 had only tendinopathy of the rotator cuff.
- Injection technique – posterolateral approach – 1.5 fingerbreadths below the posterolateral corner of the acromion. The needle was introduced along the superior border of the rotator cuff into the subacromial space. If the tip of the needle hit the undersurface of acromion, the needle was withdrawn slightly so that the material injected better. – doesn’t say how long needle was but shown that need at least 2 inches to insure get in bursa:
Posterior Acromial Injections Need 2 inch + Needles
- ARTZ Dispo, 25 mg of Sodium Hyaluronate (Seikagaku) in 2.5 mls – injected every week for 5 weeks
Results – improved VAS score from 6.4 to 1.5 (P < .0001), at a mean follow-up of 33.1 months. Improvement started 5 weeks after finishing 5 injection set. Initial Global improvement was 48% moderate to marked in hyaluronate group versus 35% of saline injected group. This was not significantly different at that point though "constant" scores were. Comment - Results were difficult to tease out of article. That's a lot of hyaluronate ($$$) and you are looking at some time for results. Would require 5 injections... Getting hyaluronate through a 2 inch 25 gauge needle would be difficult to impossible so you're looking at a 22-20 gauge spinal. Any perspectives on that would be helpful... michael kors bolsos michael kors bolsos