Skip to main content

Advertisement

SpringerLink
Log in

Short- and long-term results of clinical effectiveness of sodium hyaluronate injection in supraspinatus tendinitis

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

The objective of the study is to evaluate the short- and long-term effect of intraarticular sodium hyaluronate (SH) application in patients diagnosed with supraspinatus tendinitis (ST) that have shoulder pain on the clinical symptoms of the patients through comparison with conventional physiotherapy methods. A total of 24 patients were included in the study and were randomized into two groups.SH injection and physical therapy modalities (PTM) were administered to Group I and Group II, respectively. Home exercise programs were recommended to all of the patients in both groups. The patients were evaluated using the pain severity [Visual Analog Scale (VAS)], range of motion and functional evaluation (FE) parameters pertaining to pre-treatment, 3rd week, 3rd month and 4th year post-treatment. Patient’s global effectiveness (PGE) evaluation was performed in the 3rd month and 4th year of the treatment. There were no statistically significant differences for Group I’s resting VAS value between pre-treatment controls and controls in the 3rd week and 3rd month, no statistically significant differences were detected for Group II in passive flexion between pre-treatment and the 4th year, also in passive external rotation between pre-treatment and 3rd week (P > 0.05). A statistically significant recovery was detected in both groups in all the other evaluation parameters (P < 0.05). When evaluation was performed among groups, active abduction in the control in the 3rd month, VAS by movement and a statistically significant difference in favor of Group I in FE were determined (P < 0.05). No statistically significant differences were found among groups in PGE (P > 0.05). It was concluded that physical therapy modalities and SH application supplemented by home exercise programs were similar effects in short- and long term for ST which causes pain in shoulder and SH application may be a better alternative with regard to effectiveness and side effects for other treatment methods applied intraarticulary.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Martin SD, Thornbill TS (2001) Shoulder pain. In: Ruddy S, Harris ED, Sledge CB (eds) Kelly’s textbook of rheumatology. Saunders Co, Philadelphia W.B, pp 475–509

    Google Scholar 

  2. Skyhar MJ, Simmons TC (1992) Rehabilitation of the shoulder. In: Nickel VL, Botte MJ (eds) Orthopaedic rehabilitation. Churchill livingstone, New York, pp 747–763

    Google Scholar 

  3. Luime JJ, Koes BW, Hendriksen IJM, Burdof A, Verhagen AP, Miedema HS, Verhaar JA (2004) Prevalence and incidence of shoulder pain in the general population; a systematic review. Scan J Rheum 33:73–81

    Article  CAS  Google Scholar 

  4. Croft P, Pope D, Zonca M, O’Neill T, Silman A (1994) Measurement of shoulder related disability: results of a validation study. Ann Rheum Dis 53:525–528

    Article  PubMed  CAS  Google Scholar 

  5. Badcock LJ, Lewis M, Hay EM, McCarney R, Croft PR (2002) Chronic shoulder pain in the community: a syndrome of disability or distress? Ann Rheum Dis 61:128–131

    Article  PubMed  CAS  Google Scholar 

  6. van der Heijden GJ, van der Windt DA, Kleijnen J, Koes BW, Bouter LM (1996) Steroid injections for shoulder disorders: a systematic review of randomized clinical trials. Br J Gen Pract 46:309–316

    PubMed  Google Scholar 

  7. Cardoso de Souza M, Trajano Jorge R, Jones A, Lombardi Júnior I, Natour J (2009) Progressive resistance training in patients with shoulder impingement syndrome: literature review. Reumatismo 61(2):84–89

    PubMed  CAS  Google Scholar 

  8. van der Windt DA, van der Heijden GJ, Scholten RJ, Koes BW, Bouter LM (1995) The efficacy of non-steroidal anti-inflammatory drugs (NSAIDS) for shoulder complaints: a systematic review. J Clin Epidemiol 48:691–704

    Article  PubMed  Google Scholar 

  9. Ludewig PM, Borstad JD (2003) Effects of a home exercise programme on shoulder pain and functional status in construction workers. Occup Environ Med 60:841–849

    Article  PubMed  CAS  Google Scholar 

  10. Bang MD, Deyle GD (2000) Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome. J Orthop Sports Phys Ther 30:126–137

    PubMed  CAS  Google Scholar 

  11. Ginn KA, Herbert RD, Khouw W, Lee R (1997) A randomized, controlled clinical trial of a treatment for shoulder pain. Phys Ther 77:802–809

    PubMed  CAS  Google Scholar 

  12. Brox JI, Staff PH, Ljunggren AE, Brevik JI (1993) Arthroscopic surgery compared with supervised exercises in patients with rotator cuff disease (stage II impingement syndrome). BMJ 307:899–903

    Article  PubMed  CAS  Google Scholar 

  13. Abatangelo G, Hyaluronan O’ReganM (1995) Biological role and function in articular joints. Eur J Rheumatol Inflamm 15:9–16

    Google Scholar 

  14. Iwata H (1993) Pharmacologic and clinical aspects of intraarticular injection of hyaluronate. Clin Orthop Relat Res number 289:285–291

    Google Scholar 

  15. Tatari H, Skiak E, Destan H, Ulukuş Ç, Özer E, Satağlu S (2004) Effect of hyalan G-F 20 in Achilles’ tendonitis: an experimental study in rats. Arch Phys Med Rehabil 85:1470–1474

    Article  PubMed  Google Scholar 

  16. Amiel D, Ishizue K, Billings EJ, Wiig M, Vane Berg J, Akeson WH, Gelberman R (1989) Hylan in flexor tendon repair. J hand Surg (Am) 14:837–843

    Article  CAS  Google Scholar 

  17. Foland JW, Trotter GW, Powers BE, Wrigley RH, Smith FW (1992) Effect of sodium hyaluronate in collagenase-induced superficial digital flexor tendinitis in horses. Am J Vet Res 53(12):2371–2376

    PubMed  CAS  Google Scholar 

  18. Gaughan EM, Nixon AJ, Krook LP, Yeager AE, Mann KA, Mohammed H, Bartel DL (1991) Effects of sodium hyaluronate on tendon healing and adhesion formation in horses. Am J Vet Res 52(5):764–773

    PubMed  CAS  Google Scholar 

  19. Meyers SA, Seaber AV, Glisson RR, Nunley JA (1989) Effect of hyaluronic acid/chondroitin sulfate on healing of full-thickness tendon lacerations in rabbits. J Orthop Res 7(5):683–689

    Article  PubMed  CAS  Google Scholar 

  20. St Onge R, Weiss C, Denlinger JL, Balazs EA (1980) A preliminary assessment of Na-hyaluronate injection into “no man’s land” for primary flexor tendon repair. Clin Orthop Relat Res 146:269–275

    PubMed  Google Scholar 

  21. Thomas SC, Jones LC, Hungerford DS (1986) Hyaluronic acid and its effect on postoperative adhesions in the rabbit flexor tendon. A preliminary look. Clin Orthop Res 206:281–289

    CAS  Google Scholar 

  22. Brandt KD, Block JA, Michalski JP, Moreland LW, Caldwell JR, Lavin PT (2001) Efficacy and safety of intraarticular sodium hyaluronate in knee osteoarthritis. ORTHOVISC study group. Clin Orthop Relat Res 385:130–143

    Article  PubMed  Google Scholar 

  23. Adams ME, Lussier AJ, Peyron JG (2000) A risk-benefit assessment of injections of hyaluronan and its derivatives in the treatment of osteoarthritis of the knee. Drug Saf 23:115–130

    Article  PubMed  CAS  Google Scholar 

  24. Lohmander LS, Dalen N, Englund G, Hamalainen M, Jensen EM, Karlsson K, Odensten M, Ryd L, Sembo I, Suomalainen O, Tegnander A (1996) Intraarticular hyaluronan injections in the treatment of osteoarthritis of the knee: a randomised, double blind, placebo controlled multicentre trial. Hyaluronan multicentre trial group. Ann Rheum Dis 55:424–431

    Article  PubMed  CAS  Google Scholar 

  25. Shibata Y, Midorikawa K, Emoto G, Naito M (2001) Clinical evaluation of sodium hyaluronate for the treatment of patients with rotator cuff tear. J Shoulder Elbow Surg 10:209–216

    Article  PubMed  CAS  Google Scholar 

  26. Leardini G, Perbellini A, Franceschini M, Mattara L (1988) Intra-articuler injections of hyaluronic acid in the treatment of painful shoulder. Clin Ther 10(5):521–525

    PubMed  CAS  Google Scholar 

  27. Itokazu M, Matsunaga T (1995) Clinical evaluation of highmolecular- weight sodium hyaluronate for the treatment of patients with periarthritis of the shoulder. Clin Ther 17:946–955

    Article  PubMed  CAS  Google Scholar 

  28. Rovetta G, Monteforte P (1998) Intraarticular injection of sodium hyaluronate plus steroid versus steroid in adhesive capsulitis of the shoulder. Int J Tissue React 20:125–130

    PubMed  CAS  Google Scholar 

  29. Calis M, Demir H, Ulker S, Kirnap M, Duygulu F, Calis HT (2006) Is intraarticular sodium hyaluronate injection an alternative treatment in patients with adhesive capsulitis? Rheumatol Int 26:536–540

    Article  PubMed  CAS  Google Scholar 

  30. Meloni F, Milia F, Cayazzuti M, Doria C, Lisai P, Profili S, Meloni GB (2008) Clinical evaluation of sodium hyaluronate in the treatment of patients with supraspinatus tendinosis under echographic guide: experimental study of periarticular injections. Eur J Radiol 68(1):170–173 Epub 2007 Dec 21

    Article  PubMed  CAS  Google Scholar 

  31. Blaine T, Moskowitz R, Udell J, Skyhar M, Levin R, Friedlander J, Daley M, Altman R (2008) Treatment of persistent shoulder pain with sodium hyaluronate: a randomized, controlled trial. A multicenter study. J Bone Joint Surg Am 90(5):970–979

    Article  PubMed  Google Scholar 

  32. Williams GN, Gangel TJ, Arciero RA, Uhorchak JM, Taylor DC (1999) Comparison of the single assessment numeric evaluation method and two shoulder rating scales. Outcomes measures after shoulder surgery. Am J Sports Med 27(2):214–221

    PubMed  CAS  Google Scholar 

  33. Kibler WB, McMullen J, Uhl T (2001) Shoulder rehabilitation strategies, guidelines, and practice. Ortho Clinics N Am 32(3):527–538

    Article  CAS  Google Scholar 

  34. American Academy of Orthopedic Surgeons (2001) AAOS clinical guideline on shoulder pain: support document. American Academy of Orthopedic Surgeons, Rosemont

    Google Scholar 

  35. Van der Heijden GJ, Van der Windt DA, de Winter AF (1997) Physiotherapy for patients with soft tissue shoulder disorders: a systematic review of randomised clinical trial. Br Med J 315:25–30

    Article  Google Scholar 

  36. Albright J, Allman R, Bonfiglio RP, Conill A, Dobkin B, Guccione AA, Hasson S, Russo R, Shekelle P, Susman JL, Brosseau L, Tugwell P, Wells GA, Robinson VA, Graham ID, Shea BJ, McGowan J, Peterson J, Corriveau H, Morin M, Pelland L, Poulin L, Tousignant M, Laferrière L, Casimiro L, Tremblay LE (2001) Philadelphia Panel Evidence-Based clinical practice guidelines on selected rehabilitation interventions for shoulder pain. Phys Ther 81:1719–1730

    Google Scholar 

  37. Han SC, Harison P (1997) Myofascial pain syndrome and trigger-point management. Reg Anesth 22(1):89–101

    Article  PubMed  CAS  Google Scholar 

  38. Ginn KarenA, Herbert RobertD, Khouw Wendy, Lee Rebecca (1997) A randomized, controlled clinical trial of a treatment for shoulder pain. Phys Ther 77(8):802–809

    PubMed  CAS  Google Scholar 

  39. Wang CT, Lin J, Chang CJ, Lin YT, Hou SM (2004) Therapeutic effects of hyaluronic acid on osteoarthritis of the knee. A meta-analysis of randomized controlled trials. J Bone Joint Surg Am 86-A:538–545

    PubMed  Google Scholar 

  40. Simon LS (1999) Vicosupplementation therapy with intra-artikuler hyaluronic acid fact or fantasy. Rheum Dis Clin North Am 25(2):345–357

    Article  PubMed  CAS  Google Scholar 

  41. Dixon AS, Jacoby RK, Berry H, Hamilton EB (1988) Clinical trial of intra-articular injection of sodium hyaluronate in patiens with osteoarthritis of the knee. Curr Med Res Opin 11(4):205–213

    Article  PubMed  CAS  Google Scholar 

  42. Mitsui Y, Gotoh M, Nakama K, Yamada T, Higuchi F, Nagata K (2008) Hyaluronic acid ınhibits mRNA expression of proinflammatory cytokines and cyclooxygenase-2/prostaglandin E2 production via CD44 in interleukin-1-stimulated subacromial synovial fibroblasts from patients with rotator cuff disease. J Orthop Res 26(7):1032–1037

    Article  PubMed  CAS  Google Scholar 

  43. Shimpuku E, Hamada K, Handa A, Kobayashi K, Nakajima T, Yamazaki H, Nakamuta M, Fukuda H, Mochida J (2007) Molecular effects of sodium hyaluronate on the healing of avian supracoracoid tendon tear: according to in situ hybridization and real-time polymerase chain reaction. J Orthop Res 25(2):173–184

    Article  PubMed  CAS  Google Scholar 

  44. Salti NI, Tuel RJ, Mass DP (1993) Effect of hyaluronic acid on rabbit profundus flexor tendon healing in vitro. J Surg Res 55(4):411–415

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Eskişehir Osmangazi University, Eskisehir, Turkey

    Merih Özgen

  2. Department of Physical Medicine and Rehabilitation, Akdeniz University, Antalya, Turkey

    Sibel Fırat

  3. Department of Physical Medicine and Rehabilitation, Pamukkale University, Denizli, Turkey

    Ayşe Sarsan, Oya Topuz & Füsun Ardıç

  4. Department of Biostatistics, Eskişehir Osmangazi University, Eskisehir, Turkey

    Canan Baydemir

Authors
  1. Merih Özgen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sibel Fırat
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ayşe Sarsan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Oya Topuz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Füsun Ardıç
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Canan Baydemir
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Merih Özgen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Özgen, M., Fırat, S., Sarsan, A. et al. Short- and long-term results of clinical effectiveness of sodium hyaluronate injection in supraspinatus tendinitis. Rheumatol Int 32, 137–144 (2012). https://doi.org/10.1007/s00296-010-1577-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-010-1577-0

Keywords

Search

Navigation