Efficacy of Intra-articular Hyaluronate Injection for Adhesive Capsulitis

Efficacy of Intra-articular Hyaluronate Injection for Adhesive Capsulitis

Objective: To evaluate the efficacy of intra-articular hyaluronic acid (HA) injections for the treatment of adhesive capsulitis (AC) of the shoulder.

Design: Prospective, randomized, parallel-group interventional trial Setting: Rehabilitation department of a medical center hospital. Participants: Participants: Patients with frozen-phase primary adhesive capsulitis Interventions: The patients received intra-articular glenohumeral joint injections of HA, 60mg, once per week for 3 consecutive weeks.

Main Outcome Measures: Active and passive range of motion (ROM) of the affected shoulder; Shoulder pain and disability were measured using 2 questionnaires: the SPADI.

The patients were evaluated before treatment and were reevaluated 4, 6, 8, and 26 weeks after the beginning of the treatment.

Inclusion Criteria:

• Patients diagnosed with frozen shoulder by a clinical physician based on the patient's medical history, physical examination, X-ray, and ultrasound or magnetic resonance imaging reports.
• Clinical course: Patients must have a pain score of less than 3, no nighttime shoulder pain, and be in the post-freezing stage, primarily presenting restricted shoulder joint range of motion.
• The affected shoulder joint must have at least two angles of shoulder joint movement reduced by at least 30% compared to the healthy side: shoulder flexion, abduction, and external rotation, or a single affected side abduction angle reduced by 50% relative to the healthy side.
• Age between 40 to 70 years old.

Exclusion Criteria:

• full-thickness tear or massive tear of the rotator cuff tendons or calcific tendinitis.
• Presence of systemic rheumatic disease.
• History of shoulder fracture or previous shoulder surgery.
• Received shoulder injections for treatment within the last 3 months.
• Acute cervical nerve root compression.
• Current pregnancy or lactation.
• Patients with shoulder instability or cancer.
• Patients with cognitive impairment, unable to follow simple instructions, or unable to comply with the study procedures.