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Study aim
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A comparison between effectiveness of subacromial space injections of low MW hyaluronic acid with high MW in the treatment of rotator cuff tendinopathy.
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Design
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Single center, randomized, blinded, phase III clinical trial with a parallel group design of 56 participants with rotator cuff tendinopathy equally divided in to two groups, low MW hyaluronic acid (Hyalgan®) and high MW hyaluronic acid (Synogel®).
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Settings and conduct
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In this study participants, investigators, outcome assessors, data analyst and the quality controller are blinded and only the expert who does the injection could not be blinded because of the difference in the viscosity, and will be excluded from the investigation and follow-ups, he will only do the injection based on the code in sealed envelope provided by the investigator.
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Participants/Inclusion and exclusion criteria
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Participants will be adult patients (16-70 years old) with Rotator Cuff Tendinopathies, with onset of shoulder pain for least 6 weeks .
Pediatrics, geriatrics, pregnant, lactating, patient with active rheumatologic disorders, patient with coagulopathies, active infections in shoulder and tissues of around the shoulder, complete rupture of rotator cuff tendons, diabetes mellitus, use of anticoagulant drugs, use of systemic corticosteroid in the last month will be excluded from the study.
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Intervention groups
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Participants randomly divided in two groups of intervention, first group received low MW hyaluronic acid (500-700 KD, Hyalgan®), and the second group received high MW hyaluronic acid (>2000 KD, Synogel®).
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Main outcome variables
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The primary outcome is Visual Analog Scale (VAS).
The secondary outcomes will be: 1) the range of motions (ROM) in flexion, extension, abduction, adduction, internal and external rotation, 2) Disability of the Arm Shoulder and Hand (DASH) Questionnaire, 3) Quality Of Life (WHOQOL)-BREF.