Does Botulinum A Toxin Help With Pain From Rotator Cuff Arthropathy?

Null Hypothesis This is a pilot / feasability study. The null hypothesis is that there is no effect on the pain or oxford shoulder scores reported by patients receiving a targeted botulinum A toxin injection in the presence of cuff arthropathy at 6 weeks, 3 months or 6 months compared with the baseline values. Objectives The aim of this feasability study is to provide the necessary information for the planning of a future trial. It will test the feasibility of running such a trial and provide estimates of the differences in outcome measures and information on resource data. All potential participants for this study will be identified by an Orthopaedic Shoulder Consultant in the shoulder clinics run at the Royal Devon and Exeter NHS Trust. The patients will be screened for eligibility by a research associate (SG). The eligibility criteria will be that the patient is medically fit for an operation, and has painful rotator cuff arthropathy, that is deemed suitable for intervention by the consultant surgeon. The patients will be informed verbally and in writing about the trial by the research associate and informed consent will be taken. The participating patients will be allocated to an USS guided botox injection. All patients will be asked to complete a number of questionnaires prior to the injection: the Oxford Shoulder Score (OSS), a Visual Analogue Score (VAS) and the EQ-5D. The range of movement of the shoulder joint will be documented in the usual fashion. The injections will all be done by Dr Anaspure (Consultant Radiologist) under USS guidance in a standard manner. After the injection, patients will be reviewed using the range of movement, OSS, a patient satisfaction score and EQ-5D at 6 weeks, 3 months and 6 months post injection. A record will be kept of any complications associated with the treatment. This data will be collected by the research associate, who is independent of either intervention.