Adelmidrol plus hyaluronic acid injections in the management of shoulder impairment due to rotator cuff disease: an exploratory pilot observational retrospective investigation

Abstract

BACKGROUND: Shoulder disorders are the third most common musculoskeletal presentation in primary care. Injuries to the structures surrounding this joint are closely related to oxidative stress and can lead to rotator cuff (RC) disease, including subacromial impingement syndrome, tendinopathy, and partial thickness tears, all characterized by pain, functional impairment, and reduced quality of life. This exploratory pilot investigation evaluates the effects of 2% Adelmidrol (ADM) plus 1% hyaluronic acid (HA) subacromial injections in patients with symptomatic RC disease. METHODS: Data from 28 patients who received two ADM+HA injections (one every 7 days) were collected. Assessments included the evaluation of pain intensity with the Numeric Rating Scale (NRS) at baseline (T0), 1 week after the 1st injection (T1) and 1 month after the 2nd injection (T2); shoulder functionality by Constant Score (CS) and Simple Shoulder Test (SST) at T0 and T2; and patients' subjective health status improvement by Patients' Global Impression of Change (PGIC) at T2. RESULTS: Pain intensity showed a significant improvement over time (p < 0.0001), already evident at T1 and further at T2 (T1 vs. T0 p < 0.0001; T2 vs. T1 p < 0.0001). Shoulder functionality significantly improved from baseline to the end of the observational period (p < 0.0001), when most patients reported an overall improvement in their health status. CONCLUSION: The use of the innovative ADM and HA association showed encouraging preliminary clinical improvements in pain and function, which warrant further confirmation in controlled settings.