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What is the evidence for viscosupplementation in treating osteoarthritis of the shoulder?

Meta-Analysis

Colen, S., et al. (2012). "Hyaluronic Acid for the Treatment of Osteoarthritis in all Joints Except the Knee What is the Current Evidence?" Biodrugs 26(2): 101-112.
What's this
AMSTAR Rating
5

Summary

Patient Population:

No information on the patient population was provided.

Intervention:

Dose not reported. Most common approach used was posterior. One prospective study examined the use of injection with fluoroscopic guidance. The single RCT described either 3 or 5 injections administered at 1 week intervals. The prospective studies delivered 2 or 3 injections at various intervals ranging from 3 days to 2 weeks.

Comparison:

The authors identified a total of 6 studies examining the use of HA injections for the treatment of OA of the shoulder. One study was a RCT (n=660), the remainder were single-group prospective studies.

Outcome:

  1. Pain: In the RCT there was a significant difference in pain outcomes reported after a regimen of either 3 or 5 injections administered at 1 week intervals compared to no treatment at 3 month follow-up.
  2. Pain: 2 of the prospective studies were able to be pooled together and were associated with a significant reduction in pain over time, however, there was no comparison group.

Guideline Recommendations

Source Recommendation
AAOS 2009 Weak
ACOEM 2011 Insufficient
NICE 2008 Do Not Recommend

Outcomes Assessed

  • Benefit
  • Harm
  • Inconclusive

Viscosupplementation vs. No Treatment

Pain

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