Corticosteroid injection for rotator cuff disease

Many thanks for the response from Professor Koes.

The problem is that even if the statistically significant difference
in secondary outcome measures is not of importance, there are several
other problems which limit the significance of this study.

As the study admits the lack of a sham arm is a disadvantage. The
lack of a specific diagnosis for the patienst in the study is also a
concern; 'rotator cuff disease' is not a widely used description and does
not represent a specific shoulder pathology. When this non-specificity is
combined with the relatively small trial numbers and a treatment that may
only be slightly more efficacious, then you have the ingredients to find
less of significance than may potentially be found if things were designed
differently.

Competing interests:
None declared