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

To assess if ultrasound (US)-guided viscosupplementation can reduce pain and improve function in elderly patients with cuff tear arthropathy. 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). 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. US-guided viscosupplementation is a beneficial therapeutic option in the first months of treatment.