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Orthobiological agents such as platelet rich plasma with a low side effect rate gain importance in the conservative treatment of SIS. Currently, the knowledge about success rate influencing factors, such as the growth factors (GF) concentration or acromion type, is limited. The aim of this study was to analyze the clinical outcome in the therapy of external SIS using autologous conditioned plasma combined with recombinant human collagen scaffold (ACP\/STR) injection in comparison with a corticosteroid-local anesthetic (CSA) injection. Additionally, the influence of potential limiting factors such as GF concentration, age and acromial morphology was proved.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>This prospective pseudo-randomized trial recruited 58 patients with external SIS who received an ultrasound-guided subacromial injection either an ACP\/STR or a CSA followed by physical therapy. Follow-up (FU) was performed at 6\u00a0weeks, 3 and 6\u00a0months. The outcome was assessed with Constant\u2013Murley score, disability of arm, shoulder and hand score and simple shoulder test. The concentration of GF was measured using ELISA.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>During the FU, the improvement of outcome measures was observed with no differences between both groups. Shoulder force was significantly increased in the ACP\/STR group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). We found no correlation between the amount of GF and age or gender in the ACP\/STR patients. An acromion Bigliani type III predisposes for therapy failure (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, OR\u2009=\u200956) in both treatment groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Patients with SIS benefit regarding to PROMs after both ACP\/STR and CSA injection and physical therapy. Patients who received ACP\/STR obtained superior improvement in force. The quantity of GF did not vary depending on the age, so that ACP\/STR can be a treatment option for SIS in elderly patients with multimorbidity. The presence of an acromion type III seems to be a predictive factor for limited effectivity of injections in the clinical management of SIS.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00590-023-03595-x","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T17:02:17Z","timestamp":1685466137000},"page":"3623-3630","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Injection of autologous conditioned plasma combined with a collagen scaffold may improve the clinical outcome in shoulder impingement syndrome: a prospective study"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3404-0735","authenticated-orcid":false,"given":"Agnieszka","family":"Halm-Pozniak","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph H.","family":"Lohmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Friedemann","family":"Awiszus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margit","family":"Rudolf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Bertrand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Berth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,5,30]]},"reference":[{"key":"3595_CR1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-15-81","author":"E Roddy","year":"2014","unstructured":"Roddy E, Zwierska I, Hay EM et al (2014) Subacromial impingement syndrome and pain: protocol for a randomised controlled trial of exercise and corticosteroid injection (the SUPPORT trial). 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The grant was used to purchase ACP\/STR syringes and ELISA kits for growth factor analysis.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}