Effect of sodium hyaluronate treatment on rotator cuff lesions without complete tears: A randomized, double-blind, placebo-controlled study

被引:80
作者
Chou, Wen-Yi [1 ,2 ]
Ko, Jih-Yang [1 ,2 ,3 ]
Wang, Feng-Sheng [2 ,3 ,4 ]
Huang, Chung-Cheng [2 ,5 ]
Wong, To [1 ,2 ,3 ]
Wang, Ching-Jen [1 ,2 ,3 ]
Chang, Hui-E [2 ,4 ]
机构
[1] Chang Gung Mem Hosp, Kaohsiung Med Ctr, Dept Orthopaed Surg, Kaohsiung, Taiwan
[2] Chang Gung Univ, Coll Med, Kaohsiung, Taiwan
[3] Chang Gung Mem Hosp, Kaohsiung Med Ctr, Grad Inst Clin Med Sci, Kaohsiung, Taiwan
[4] Chang Gung Mem Hosp, Kaohsiung Med Ctr, Dept Med Res, Kaohsiung, Taiwan
[5] Chang Gung Mem Hosp, Kaohsiung Med Ctr, Dept Diagnost Radiol, Kaohsiung, Taiwan
关键词
Rotator cuff lesion; hyaluronate; subacromial injections; placebo; randomized; Constant score; IN-SITU HYBRIDIZATION; CLINICAL-EVALUATION; PAINFUL SHOULDER; MOLECULAR-WEIGHT; SYNOVIAL-FLUID; INJECTIONS; CARTILAGE; RECEPTOR; TENDONS; CD44;
D O I
10.1016/j.jse.2009.08.006
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Hypothesis: A randomized, double-blind, placebo-controlled study of sodium hyaluronate (ARTZ Dispo) treatment was performed in 51 patients with rotator cuff lesions without complete tears. We hypothesized that ARTZ Dispo would render better results than the placebo. Materials and methods: Twenty-five patients (ARTZ Dispo group) had injections of 25 mg/wk of sodium hyaluronate into the subacromial bursa for 5 consecutive weeks. Twenty-six patients (placebo group) were given 2.5 mL of normal saline solution with the same injection protocol as the ARTZ Dispo group. No significant difference in an, height, weight, gender, vocation, involved shoulder, duration of symptoms, baseline Constant score, or visual analog scale (VAS) score existed between the 2 groups. Results: The 2 groups did not significantly differ with regard to Constant scores, VAS scores, or global improvement assessments 1 week after injections. The ARTZ Dispo group had a better Constant score (P=.0095) and VAS score (P=.0018) than the placebo group 6 weeks after treatment. Patients in the placebo group were given 5 sodium hyaluronate injections, rather than placebo, after disclosure of the blind list, if they wished. Forty-one patients who underwent hyaluronate injection exhibited a significantly improved Constant score. from 64.0 +/- 11.7 at baseline to 88.9 +/- 10.4 (P<.0001), and a significantly improved VAS score, from 6.4 +/- 1.3 to 1.5 +/- 1.6 (P<.0001), at a mean follow-up of 33.1 months. No significant adverse effect was noted. Conclusions: Subacromial injections of sodium hyaluronate are effective in treating rotator cuff lesions without complete tears.
引用
收藏
页码:557 / 563
页数:7
相关论文
共 43 条
[1]
Diagnosis and treatment of chronic painful shoulder: Review of nonsurgical interventions [J].
Andrews, JR .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2005, 21 (03) :333-347
[2]
CD44 IS THE PRINCIPAL CELL-SURFACE RECEPTOR FOR HYALURONATE [J].
ARUFFO, A ;
STAMENKOVIC, I ;
MELNICK, M ;
UNDERHILL, CB ;
SEED, B .
CELL, 1990, 61 (07) :1303-1313
[3]
Treatment of persistent shoulder pain with sodium hyaluronate: A randomized, controlled trial [J].
Blaine, Theodore ;
Moskowitz, Roland ;
Udell, James ;
Skyhar, Michael ;
Levin, Robert ;
Friedlander, Jeffrey ;
Daley, Michael ;
Altman, Roy .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2008, 90A (05) :970-979
[4]
Rotator cuff: Evaluation with fast spin-echo versus conventional spin-echo MR imaging [J].
Carrino, JA ;
McCauley, TR ;
Katz, LD ;
Smith, RC ;
Lange, RC .
RADIOLOGY, 1997, 202 (02) :533-539
[5]
A review of the Constant score: Modifications and guidelines for its use [J].
Constant, Christopher R. ;
Gerber, Christian ;
Emery, Rogerj. H. ;
Solbjerg, Jens Ole ;
Boileau, Pascal .
JOURNAL OF SHOULDER AND ELBOW SURGERY, 2008, 17 (02) :355-361
[6]
CONSTANT CR, 1987, CLIN ORTHOP RELAT R, P160
[7]
THE HYALURONATE RECEPTOR IS A MEMBER OF THE CD44 (H-CAM) FAMILY OF CELL-SURFACE GLYCOPROTEINS [J].
CULTY, M ;
MIYAKE, K ;
KINCADE, PW ;
SILORSKI, E ;
BUTCHER, EC ;
UNDERHILL, C .
JOURNAL OF CELL BIOLOGY, 1990, 111 (06) :2765-2774
[8]
Impingement syndrome: Temporal outcomes of nonoperative treatment [J].
Cummins, Craig A. ;
Sasso, Lisa M. ;
Nicholson, Daniel .
JOURNAL OF SHOULDER AND ELBOW SURGERY, 2009, 18 (02) :172-177
[9]
CONCENTRATION AND MOLECULAR-WEIGHT OF SODIUM HYALURONATE IN SYNOVIAL-FLUID FROM PATIENTS WITH RHEUMATOID-ARTHRITIS AND OTHER ARTHROPATHIES [J].
DAHL, LB ;
DAHL, IMS ;
ENGSTROMLAURENT, A ;
GRANATH, K .
ANNALS OF THE RHEUMATIC DISEASES, 1985, 44 (12) :817-822
[10]
Fukuda K, 1996, J PHARMACOL EXP THER, V277, P1672