Thursday, April 18, 2013

Non operative treatment of shoulder arthritis - injections

Sodium hyaluronate for the treatment of chronic shoulder pain associated with glenohumeral osteoarthritis: a multicenter, randomized, double-blind, placebo-controlled trial

This is a double-blind, randomized, controlled multicenter trial of 300 patients with glenohumeral arthritis, half of which received hyaluronate injections and half of which received phosphate-buffered saline in 3 weekly injections. Inclusion criteria included age 35 years or older, initial visual analog score for shoulder pain on movement of 50 mm or greater, chronic shoulder pain lasting more than 6 months but less than 3 years, willing to discontinue all pain medication for at least 24 hours before each visit, and no modification of the pain medication regimen in the previous 4 weeks. Key exclusion criteria included severe joint effusion, structural defects requiring surgical management, corticosteroid injection in any joint(s) in the previous 3 months, surgical interventions in the trial shoulder within the previous 2 years, and inflammatory arthropathy of the trial shoulder. Patients were followed for 26 weeks.

Interestingly, both groups improved on their pain scores and their functional outcome scores. While the scores were somewhat better for the hyaluronate group, the differences were not statistically significant. The rates of adverse events were greater for the hyaluronate group, but again the differences were not significant. Neither group reported serious treatment-related adverse events.

This is a model Level one study and worthy of reading in full. 

The optimal non-operative management for patients with shoulder arthritis needs to be individualized. Our current preference in most cases is gentle range of motion exercises and non-narcotic analgesics.

Use the "Search" box to the right to find other topics of interest to you.

You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and runreverse total shoulderCTA arthroplasty, and rotator cuff surgery.

See from which cities our patients come.

See the countries from which our readers come on this post.