Next article Search Articles Instructions for authors  Access Statistics | Citation Manager  
REVIEW ARTICLE  
[LN]

 Article Access Statistics
    Viewed1445    
    Printed50    
    Emailed5    
    PDF Downloaded2    
    Comments [Add]    

Recommend this journal

Intra-articular infiltration therapy for patients with glenohumeral osteoarthritis: A systematic review of the literature


1 Department of Orthopaedic Surgery, University Hospitals Leuven, Pellenberg, Belgium; Department of Orthopaedic Surgery and Traumatology, Hümmling Hospital Sögel, Sögel, Germany,
2 Department of Orthopaedic Surgery, Gemini Hospital, Den Helder, Amsterdam, the Netherlands,
3 Department of Orthopaedic Surgery, Slotervaart Hospital, Amsterdam, the Netherlands,
4 Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands,

Correspondence Address:
Sascha Colen
Department of Orthopaedic Surgery and Traumatology, Hümmling Hospital Sögel, Mühlenstrasse 17, 49751 Sögel, Germany

Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6042.145252

Get Permissions

Year : 2014  |  Volume : 8  |  Issue : 4  |  Page : 114-121

 

SEARCH
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles

  Article in PDF (748 KB)
Email article
Print Article
Add to My List
Background: Conservative treatments are especially in patients with glenohumeral osteoarthritis (GH-OA) important, since shoulder arthroplasty has its limitations. In this systematic review, we will evaluate the current evidence regarding the efficacy of intra-articular (IA) infiltration treatment options in patients with GH-OA. Materials and Methods: The following databases are searched: Pubmed/Medline, Cochrane Clinical Trial Register, Embase and the WHO clinical trial register. All IA injection products used for the treatment of shoulder OA in humans are included. Results: A total of 8 studies could be included in this review. Hyaluronic acid (HA) showed effect sizes of 2.07, 2.02 and 2.11 at 6, 12 and 26 weeks follow-up, respectively. Placebo (1.60, 1.82 and 1.68) also showed stable effect sizes at the same time points. The efficacy of corticosteroids (CS) decreased rapidly at follow-up (1.08, 0.43 and 0.19). Although statistical significant, the maximum difference in effect sizes between HA and placebo was only 0.43 with absolute values between 2.0 and 6.4 on a 100-point visual analogue score for pain. Conclusion: IA treatment with HA has a good efficacy at follow-up compared to baseline. However, the difference in efficacy between HA and placebo never reaches the minimal clinically important difference at any of the follow-up points. We are not able to give clear recommendations for the use of IA CS injections in patients with GH-OA. In future research, we recommend focusing on sufficiently powered randomized trials to compare the efficacies of HA, CS, placebo and other IA treatment options in patients with GH-OA.






[FULL TEXT] [PDF]*
 

 


 

 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 
 
 Reader Comments
 Email Alert *
  *
 * Requires registration (Free)
 
 REVIEW ARTICLE
 




1 Department of Orthopaedic Surgery, University Hospitals Leuven, Pellenberg, Belgium; Department of Orthopaedic Surgery and Traumatology, Hümmling Hospital Sögel, Sögel, Germany,
2 Department of Orthopaedic Surgery, Gemini Hospital, Den Helder, Amsterdam, the Netherlands,
3 Department of Orthopaedic Surgery, Slotervaart Hospital, Amsterdam, the Netherlands,
4 Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands,

Correspondence Address:
Sascha Colen
Department of Orthopaedic Surgery and Traumatology, Hümmling Hospital Sögel, Mühlenstrasse 17, 49751 Sögel, Germany

Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6042.145252

Get Permissions

Background: Conservative treatments are especially in patients with glenohumeral osteoarthritis (GH-OA) important, since shoulder arthroplasty has its limitations. In this systematic review, we will evaluate the current evidence regarding the efficacy of intra-articular (IA) infiltration treatment options in patients with GH-OA. Materials and Methods: The following databases are searched: Pubmed/Medline, Cochrane Clinical Trial Register, Embase and the WHO clinical trial register. All IA injection products used for the treatment of shoulder OA in humans are included. Results: A total of 8 studies could be included in this review. Hyaluronic acid (HA) showed effect sizes of 2.07, 2.02 and 2.11 at 6, 12 and 26 weeks follow-up, respectively. Placebo (1.60, 1.82 and 1.68) also showed stable effect sizes at the same time points. The efficacy of corticosteroids (CS) decreased rapidly at follow-up (1.08, 0.43 and 0.19). Although statistical significant, the maximum difference in effect sizes between HA and placebo was only 0.43 with absolute values between 2.0 and 6.4 on a 100-point visual analogue score for pain. Conclusion: IA treatment with HA has a good efficacy at follow-up compared to baseline. However, the difference in efficacy between HA and placebo never reaches the minimal clinically important difference at any of the follow-up points. We are not able to give clear recommendations for the use of IA CS injections in patients with GH-OA. In future research, we recommend focusing on sufficiently powered randomized trials to compare the efficacies of HA, CS, placebo and other IA treatment options in patients with GH-OA.






[FULL TEXT] [PDF]*


        
Print this article     Email this article