الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 91 |  |  |
| | | from | 91 | | |
Abstract
Subacromial impingement syndrome (SIS) is the most commonly reported shoulder pathology that affects various aspects of patients’ daily activities. It implies the mechanical compression of rotator cuff tendons, long head of biceps and subacromial/subdeltoid bursae under the coracoacromial arch.
Several factors are thought to be involved, such as acromioclavicular joint arthritis, acromial spurs, weakness of rotator cuff muscles, rotator cuff tendinopathy and abnormal kinematic pattern of periscapular muscles. Some or all of these factors work together resulting in the reduction of the potential space for rotator cuff tendons in the subacromial space and thus triggers the pathological cascade associated with the development of SIS.
Treatment remains controversial as implicated by its multifactorial nature and its disparate theories of pathogenesis. L-GF has proved to be a safe and effective novel management option for different degenerative musculoskeletal disorders. It is thus interesting to study its effect on SIS.
Our objective was to evaluate the efficacy of ultrasound-guided injection of platelet-derived lyophilized growth factors in treatment of subacromial impingement.
Sixty patients with SIS were included in the study. Patients were identified as having SIS when clinically they had anterolateral shoulder pain, a painful arc of motion and positive impingement signs (Neer’s or Hawkins-Kennedy). Ultrasonographic confirmation of the diagnosis was through the elicitation of a transient arc of pain during shoulder abduction which coincides with passage of the supraspinatus insertion beneath the coracoacromial arch. Exclusion criteria included previous shoulder surgery, fracture, dislocation or the presence of a frozen shoulder or a full-thickness supraspinatus tendon tear.