Intralesional Versus Perilesional 5% Dextrose Injection in Partial Rotator Cuff Tears

Inclusion Criteria: * Diagnosis of partial rotator cuff tear by a specialist physician after appropriate clinical examination and imaging evaluation * Shoulder pain and functional limitation lasting for at least 3 months * Clinically confirmed shoulder impingement findings, defined as at least one positive test among Neer, Hawkins-Kennedy, or painful arc tests * Age between 18 and 75 years * Ability to comply with the study procedures and attend follow-up visits regularly * Willingness to participate in the study and provide written informed consent Exclusion Criteria: * Advanced cognitive impairment or dementia preventing reliable completion of questionnaires * Refusal to participate in the study or inability to provide informed consent * Full-thickness rotator cuff tear * Major tendon pathology other than the supraspinatus tendon, such as full-thickness subscapularis tear or biceps tendon rupture * Advanced acromioclavicular joint osteoarthritis, marked impingement, or marked adhesive capsulitis * Advanced glenohumeral joint arthritis * Active infection, cellulitis, or dermatologic lesion at the injection site * Bleeding diathesis or anticoagulant use * Known allergy or intolerance to dextrose injection * Intra-articular shoulder injection, including steroid, platelet-rich plasma, or prolotherapy, within the last 3 months * Previous shoulder surgery * Uncontrolled diabetes mellitus, defined as HbA1c \>8.5%, or severe endocrine or metabolic disorder * Immunosuppression or active infection * Rheumatologic shoulder involvement * Neurological disease affecting shoulder movements * Pregnancy * Active malignancy