Abstract

Pain syndrome in the shoulder occurs in every 5th adult and is the 2nd most frequent reason for seeking primary medical care among all musculoskeletal disorders. Group of local causes of pain syndrome in the shoulder area. The starting point for differential search is patient’s age. For persons younger than 40, the most common causes are joint instability (dislocations / subluxations), as well as mild damage of the rotator cuff muscles due to injury. Patients older than 40 have an increased risk of severe chronic disorders of the above-mentioned muscles, adhesive capsulitis, and osteoarthritis of the shoulder joint. Treatment of shoulder joint and soft tissue pathology is nosological in nature and has to be justified by pathogenesis. Chondroreparants are a new class of pharmaceuticals based on hyaluronic acid modified by low molecular weight compounds using solid-phase stabilization. During physical stabilization (mechanosynthesis) of hyaluronic acid, chemical crosslinkers are not used, which leads to high tolerability and safety. Modified hyaluronic acid in Hyalrepair formulas has a number of structural features leading to its slower biodegradation in the tissues. Chondroreparant Hyalrepair-10 consists of hyaluronic acid, ascorbyl phosphate, zinc, cysteine, and glutathione; Hyalrepair- 2 consists of hyaluronic acid, ascorbyl phosphate, L-proline, L-lysine, and glycine. Use of intra-joint and periarticular injection of hyaluronic acid can be an effective approach in combination pathogenesis-directed therapy of the shoulder and soft tissues.

Highlights

  • Ключевые слова: патология плечевого сустава, болевой синдром, тендинит, вращательная манжета плеча, раз‐ рывы, синдром субакромиального соударения, импинджмент-синдром, диагностические тесты, патогенетическая терапия, ортобиологическая терапия, гиалуроновая кислота, хондрорепарант, Гиалрипайер

  • Treatment of shoulder joint and soft tissue pathology is nosological in nature and has to be jus‐ tified by pathogenesis

  • Chondroreparants are a new class of pharmaceuticals based on hyalur­onic acid modified by low molecular weight compounds using solid-phase stabilization

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Summary

Пораженная структура Affected structure

Отведение руки (средний сектор дуги Дауборна) Arm abduction (median sector of the coracoacromial arch). Максимальный подъем руки вверх (верхний сектор дуги Дауборна) Maximal vertical arm elevation (upper sector of the coracoacromial arch). Наружняя ротация (попытка причесаться) External rotation (attempt to brush hair). Внутренняя ротация (попытка завести руку за спину) Internal rotation (attempt to bring the arm behind the back). Сгибание в локтевом суставе и супинация предплечья (подъем тяжести, поворот ключа в двери кнаружи) Elbow joint flexion and forearm supination (heavy load picking, external rotation of a key in a lock). Нарушенность (болезненность и / или ограниченность) всех видов движения All movements are abnormal (painful and / or limited). Боль в области плечевого сустава, не связанная с движениями в плечевом суставе Pain in the shoulder joint area not associated with any movements in the joint.

Сухожилие двуглавой мышцы плеча Tendon of the bicep
Диагностика Diagnosis
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