Ultrasound-guided viscosupplementation of subacromial space in elderly patients with cuff tear arthropathy using a high weight hyaluronic acid: Prospective open-label non-randomized trial

Objective: To assess if ultrasound (US)-guided viscosupplementation can reduce pain and improve function in elderly patients with cuff tear arthropathy. Patients and methods: Ninety-three patients aged over 65 with grade 3 or above cuff tear arthropathy were included in this prospective open-label non-randomized trial. Institutional review board approval and informed consent were obtained. Thirty-three patients received intra-articular injections of sodium hyaluronate under US guidance. Sixty patients constituted the control group. Shoulder joint function was assessed with Constant scores (CS) and pain with a visual analogue scale (VAS). Results: Compared with controls, treated patients reported a significant decrease in symptoms at 1 (mean CS 66∈±∈3.1 vs 37∈±∈6.9; mean VAS 1.9∈±∈1.2 vs 6.9∈±∈2.2), 2 (mean CS 65∈±∈3.2 vs 35∈±∈7.2; mean VAS 1.7∈±∈1.2 vs 6.8∈±∈2.5), 3 (mean CS 66∈±∈3.4 vs 33 6.1; mean VAS 2.3∈±∈1.2 vs 6.6∈±∈1.9), and 4 (mean CS 62∈±∈3.0 vs 34∈±∈6.5; mean VAS 3.3∈±∈1.4 vs 7.8∈±∈3.1) months, p∈<∈0.001. After 5 months there were no differences. Conclusion: US-guided viscosupplementation is a beneficial therapeutic option in the first months of treatment © 2010 European Society of Radiology.