Hylan G-F 20 Versus Triamcinolone in the Treatment of Primary Shoulder Osteoarthritis. Randomized Trial

Abstract

Introduction The aim of this study was to evaluate the effect of using an intra-articular injection of hylan G-F 20 (HA group) on primary shoulder osteoarthritis compared with an intra-articular triamcinolone injection (T group). Materials and Methods The patients were randomized into 2 groups: in the HA group a single dose of intra-articular hylan G-F 20 was administered and in the T control group a dose of triamcinolone 20 mg was administered. The participants were evaluated at 1 week, 1, 3, and 6 months after the procedure. The patients were evaluated for pain, range of motion, Constant score, modified UCLA score, and SPADI. Results Seventy patients met the inclusion criteria and were randomized to the HA (38) and T (32) groups. Improvements in range of motion were significant (p > 0.05). We observed decreases in the general visual analog scale (VAS) for pain in both groups, especially in the cases of mild and moderate arthritis that received hyaluronic acid (mean values from 8.1 initially to 4.9 after 6 months) (p = 0). Conclusions Both injections led to a decrease in pain and an increase in patient satisfaction. The results tend to be better and longer lasting in patients receiving hyaluronic acid. Level of evidence II b; Cohort study.

Efficacy of intra‐articular injections of hyaluronic acid in patients with glenohumeral joint osteoarthritis: A systematic review and meta‐analysis

“…19 A total number of injections as low as 1 demonstrated significant improvement of outcome parameters compared to baseline as well as in comparison to alternative interventions such as PT 17,20,22,23,25,26,29 or corticosteroid injections. 29 While there have been efforts to determine the optimal number of HA injections in knee OA, the data published are conflicting and do not clearly favor a certain range. 40,41 Also, currently there is insufficient evidence specific to shoulder OA to analyze the optimal formulation of HA and whether LMW or HMW preparations have a superior clinical effect.…”

“…The included studies have been published in the last 15 years (from 2007 to 2022). Nine v 6,17–24 (60.0%) were conducted in Europe (six studies 6,17–19,21,24 from Italy, one study 23 from England, one study 22 from France, and one study 20 from the Netherlands) and six studies 25–30 (40.0%) were conducted in the Americas (five studies 25–28,30 from the United States and one study 29 from Brazil). A total of 1023 subjects were analyzed, whereas 397 subjects were included in the comparator group (undergoing no intervention, PT, corticosteroid injection, and PRP injection).…”

“…| 2355 optimal time interval between injections. While a weekly administration is the most common injection interval, the total number of injections ranges from 1 17,20,22,23,25,26,29 to 5. 19 A total number of injections as low as 1 demonstrated significant improvement of outcome parameters compared to baseline as well as in comparison to alternative interventions such as PT 17,20,22,23,25,26,29 or corticosteroid injections.…”

“…While a weekly administration is the most common injection interval, the total number of injections ranges from 1 17,20,22,23,25,26,29 to 5. 19 A total number of injections as low as 1 demonstrated significant improvement of outcome parameters compared to baseline as well as in comparison to alternative interventions such as PT 17,20,22,23,25,26,29 or corticosteroid injections. 29 While there have been efforts to determine the optimal number of HA injections in knee OA, the data published are conflicting and do not clearly favor a certain range.…”

“…The included studies have been published in the last 15 years (from 2007 to 2022). Nine v 6,17-24 (60.0%) were conducted in Europe (six studies 6,[17][18][19]21,24 from Italy, one study 23 from England, one study 22 from France, and one study 20 from the Netherlands) and six studies [25][26][27][28][29][30] (40.0%) were conducted in the Americas (five studies [25][26][27][28]30 from the United States and one study 29 from Brazil).…”