HYALURONIC ACID
Strong evidence supports that there is no benefit to the use of hyaluronic acid in the treatment of glenohumeral joint osteoarthritis

Rationale

There were 2 randomized- controlled studies that were evaluated. In Blain et al, an industry sponsored study, it did not meet its primary endpoint as there was no difference in pain scores at 13 weeks when comparing hyaluronic acid to phosphate-buffered saline solution. Kwon et al, was also an industry sponsored study and Food and Drug Administration Investigational Device Exemption (G060225) that was established to assess the safety and effectiveness of 3 weekly intra-articular injections of HA compared with saline. The patients enrolled in the study consisted of mixed pathologies in addition to glenohumeral osteoarthritis. Neither visual analog scores nor outcome measures in Rheumatoid Clinical Trials-Osteoarthritis Research Society International (OMERACT-OARSI) met statistical significance at 26 weeks. In addition, injections were given blindly and with minimal patients receiving ultrasound or fluoroscopic injections.

Two other studies by the same author (DiGiacomo et al) were reviewed and were of lesser quality.

 

Strength of Evidence (quality of evidence): Strong

 

Cost Effectiveness/Resource Utilization:

There is added cost without any benefit. 


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