Ultrasound-guided intra-articular drug injection for shoulder pain after rotator cuff repair: a clinical study

doi:10.3877/cma.j.issn.1672-6448.2026.01.009

Abstract

Abstract:

Objective

To evaluate the clinical efficacy of ultrasound-guided intra-articular injection of corticosteroids via the posterior shoulder approach or anterior rotator interval approach for persistent shoulder pain after rotator cuff repair.

Methods

A total of 75 patients with shoulder pain following rotator cuff repair admitted to the Department of Orthopedics, the First Medical Center of Chinese People's Liberation Army General Hospital from June 2023 to June 2024 were retrospectively enrolled. According to whether tenotomy of the long head of the biceps brachii was performed intraoperatively, the patients were divided into two groups: Group A (38 cases) underwent rotator cuff repair combined with tenotomy of the long head of the biceps brachii) and received posterior intra-articular shoulder injection, while Group B (37 cases) underwent rotator cuff repair alone and received intra-articular shoulder injection via the anterior rotator interval. The injection regimen consisted of 1 ml diprospan plus 9 ml 0.2% ropivacaine. The visual analogue scale (VAS), Constant–Murley score (CMS), University of California, Los Angeles shoulder score (UCLA), Sports Injury Rehabilitation Adherence Scale (SIRAS), and Likert satisfaction scale were adopted to evaluate clinical outcomes at 1 week, 3 months, and 6 months after injection. Imaging examinations were performed to assess the retear rate of the rotator cuff.

Results

Overall differences in VAS, CMS, and UCLA scores between baseline and postoperative time points were statistically significant (P＜0.05). The preoperative VAS score was 7 (6, 8), which decreased to 4(3, 5) at 1 week postoperatively, 4 (3, 4) at 3 months, and 3 (3, 4) at 6 months. The preoperative CMS and UCLA scores were 49 (45, 55) and 16 (15, 17), respectively, and increased to 80 (80, 82) and 26 (26, 26) at 6 months postoperatively. Compared with baseline, the differences of all scale scores at each follow-up time point after treatment were statistically significant (adjusted P＜0.05). The preoperative SIRAS score was 4 (3, 5), while postoperative SIRAS scores were all ≥13.0, indicating good rehabilitation adherence. The preoperative Likert satisfaction scale score was 3 (3, 3), which improved to 5 (4, 5) at 6 months after operation. There were no significant differences in all scale scores between Group A and Group B before treatment as well as at 1 week, 3 months, and 6 months after treatment (all P＞0.05). Rotator cuff retear occurred in 2 cases in Group A (2/38, 5.2%) and in 1 case in Group B (1/37, 2.7%).

Conclusion

Ultrasound-guided intraarticular corticosteroid injection via both the posterior shoulder and anterior rotator interval approaches are safe and effective in relieving shoulder pain and improving shoulder function after rotator cuff repair.

Key words: Rotator cuff repair, Interventional ultrasound, Rotator cuff interval, Corticosteroid

Qiuya Yang, Yukun Luo, Yuexiang Wang. Ultrasound-guided intra-articular drug injection for shoulder pain after rotator cuff repair: a clinical study[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2026, 23(01): 60-66.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2026.01.009

https://chaosheng.cma-cmc.com.cn/EN/Y2026/V23/I01/60

Figures/Tables 5

References 30

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量表名称	例数	治疗前评分	治疗后1周评分	治疗后3个月评分	治疗后6个月评分	H值	P值
VAS	75	7（6，8）	4（3，5）^a	4（3，4）^a	3（3，4）^ab	212.47	＜0.001
UCLA	75	16（15，17）	26（23，26）^a	26（23，26）^a	26（26，26）^ab	201.39	＜0.001
CMS	75	49（45，55）	80（78，80）^a	82（80，82）^ab	80（80，82）^ab	220.63	＜0.001
SIRAS	75	4（3，5）	13（12，14）^a	13（12，14）^a	14（14，14）^ab	193.85	＜0.001
Likert	75	3（3，3）	5（4，5）^a	5（4，5）^a	5（4，5）^a	185.72	＜0.001

量表名称	例数	治疗前评分	治疗后1周评分	治疗后3个月评分	治疗后6个月评分	H值	P值
VAS	75	7（6，8）	4（3，5）^a	4（3，4）^a	3（3，4）^ab	212.47	＜0.001
UCLA	75	16（15，17）	26（23，26）^a	26（23，26）^a	26（26，26）^ab	201.39	＜0.001
CMS	75	49（45，55）	80（78，80）^a	82（80，82）^ab	80（80，82）^ab	220.63	＜0.001
SIRAS	75	4（3，5）	13（12，14）^a	13（12，14）^a	14（14，14）^ab	193.85	＜0.001
Likert	75	3（3，3）	5（4，5）^a	5（4，5）^a	5（4，5）^a	185.72	＜0.001

项目	例数	治疗前评分	治疗后1周评分	治疗后3个月评分	治疗后6个月评分	H值	P值
疼痛程度	75	5（5，5）	10（10，15）^a	15（15，15）^ab	15（10，15）^ab	207.31	＜0.001
日常功能活动	75	2（2，6）	10（8，10）^a	10（8，10）^a	10（8，10）^a	196.84	＜0.001
肩关节活动范围	75	23（22，26）	34（32，35）^a	35（34，35）^ab	35（33，35）^ab	215.49	＜0.001
肌力	75	20（20，20）	25（25，25）^a	25（25，25）^a	25（25，25）^a	189.26	＜0.001

项目	例数	治疗前评分	治疗后1周评分	治疗后3个月评分	治疗后6个月评分	H值	P值
疼痛程度	75	5（5，5）	10（10，15）^a	15（15，15）^ab	15（10，15）^ab	207.31	＜0.001
日常功能活动	75	2（2，6）	10（8，10）^a	10（8，10）^a	10（8，10）^a	196.84	＜0.001
肩关节活动范围	75	23（22，26）	34（32，35）^a	35（34，35）^ab	35（33，35）^ab	215.49	＜0.001
肌力	75	20（20，20）	25（25，25）^a	25（25，25）^a	25（25，25）^a	189.26	＜0.001

组别	例数	治疗前	治疗后1周	治疗后3个月	治疗后6个月
VAS评分
A组	38	7（6，8）	4（3，5）	4（3，5）	3（3，4）
B组	37	7（6，8）	4（3，4）	4（3，4）	3（3，4）
Z值		0.12	0.34	0.21	0.45
P值		0.904	0.732	0.835	0.652
UCLA评分
A组	38	16（15，17）	26（23，26）	26（23，26）	26（26，26）
B组	37	15（15，17）	26（23，26）	26（23，26）	26（26，26）
Z值		0.09	0.18	0.22	0.15
P值		0.928	0.857	0.825	0.881
CMS评分
A组	38	49（45，55）	80（78，80）	82（80，82）	80（80，82）
B组	37	49（45，55）	80（78，80）	80（80，82）	80（80，82）
Z值		0.11	0.08	1.56	0.19
P值		0.912	0.936	0.119	0.848
SIRAS评分
A组	38	4（3，5）	13（12，14）	13（12，14）	14（14，14）
B组	37	4（4，5）	14（13，14）	13（13，14）	14（14，14）
Z值		0.23	0.87	0.19	0.32
P值		0.818	0.384	0.849	0.749
Likert评分
A组	38	3（2，3）	5（4，5）	5（4，5）	5（5，5）
B组	37	3（3，3）	5（4，5）	5（5，5）	5（5，5）
Z值		0.17	0.26	0.41	0.29
P值		0.865	0.795	0.682	0.772

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