Comparative study of non-complicated painful shoulder syndrome treatment by glucocorticoid and anesthetic combination and the factor of interleukin 1 receptor inhibition (Orthokine)

Abstract

The aim of the study was to compare treatment of non-complicated painful shoulder syndrome (PSS) by injections of combines anesthetic Procain (0,5-10% Novocain) and glucocorticoid Betamethasone (Dyprospan 1 ml) (DN) and by injection of autologous conditioned serum with high content of interleukin 1 Pa receptor antagonist (Orthokine, OK). We studied proximate results within 6 months. Thirty three patients (18 males and 15 females) were included in OK group within age range 35-80 years. Seventy patients were enrolled in DN group (40 males and 30 females) within age range 35-72 years without endocrine disorders. All patients were assessed by visual analogous pain score (0-10), underwent physical exam with palpation of painful points and examination of shoulder biomechanics by the original PSS severity scale, X-ray and magnetic resonance imaging of painful shoulder joints. Injections were performed in the maximally painful areas with inflammatory changes verified by MRI. Each patient of OK group underwent 6 injections with 4-6 day interval. The same interval was for DN group, the number of injections were 3-5. In the OK group alleviation of pain and shoulder biomechanics occurred only after 3-4 injections with gradual improvement, whereas DN injections relieved pain and improved shoulder mobility already after 1-2 injections without further enhancement of the effect. Side effects were encountered in 70% of DN group patients, in 10% of them treatment was withdrawn. No side effects or allergic reactions were seen in OK group. The effect of OK occurs later, is less prominent, but tends to increase to compare with DN injections, however, OK is more safe and tolerable and may be the technique of choice in patients with PSS and endocrine disorders.