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Intra-articular infiltration therapy for patients with glenohumeral osteoarthritis: A systematic review of the literature.

Colen S, Geervliet P, Haverkamp D, Van Den Bekerom MP - Int J Shoulder Surg (2014)

Bottom Line: Placebo (1.60, 1.82 and 1.68) also showed stable effect sizes at the same time points.Although statistical significant, the maximum difference in effect sizes between HA and placebo was only 0.43 with absolute values between 2.0 and 6.4 on a 100-point visual analogue score for pain.IA treatment with HA has a good efficacy at follow-up compared to baseline.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, University Hospitals Leuven, Pellenberg, Belgium ; Department of Orthopaedic Surgery and Traumatology, Hümmling Hospital Sögel, Sögel, Germany.

ABSTRACT

Background: Conservative treatments are especially in patients with glenohumeral osteoarthritis (GH-OA) important, since shoulder arthroplasty has its limitations. In this systematic review, we will evaluate the current evidence regarding the efficacy of intra-articular (IA) infiltration treatment options in patients with GH-OA.

Materials and methods: The following databases are searched: Pubmed/Medline, Cochrane Clinical Trial Register, Embase and the WHO clinical trial register. All IA injection products used for the treatment of shoulder OA in humans are included.

Results: A total of 8 studies could be included in this review. Hyaluronic acid (HA) showed effect sizes of 2.07, 2.02 and 2.11 at 6, 12 and 26 weeks follow-up, respectively. Placebo (1.60, 1.82 and 1.68) also showed stable effect sizes at the same time points. The efficacy of corticosteroids (CS) decreased rapidly at follow-up (1.08, 0.43 and 0.19). Although statistical significant, the maximum difference in effect sizes between HA and placebo was only 0.43 with absolute values between 2.0 and 6.4 on a 100-point visual analogue score for pain.

Conclusion: IA treatment with HA has a good efficacy at follow-up compared to baseline. However, the difference in efficacy between HA and placebo never reaches the minimal clinically important difference at any of the follow-up points. We are not able to give clear recommendations for the use of IA CS injections in patients with GH-OA. In future research, we recommend focusing on sufficiently powered randomized trials to compare the efficacies of HA, CS, placebo and other IA treatment options in patients with GH-OA.

No MeSH data available.


Related in: MedlinePlus

Pooled effect sizes and standard deviations placebo
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Figure 3: Pooled effect sizes and standard deviations placebo

Mentions: From the studies of Blaine et al.[14] and Kwon et al.[10] an effect size for placebo could be calculated. As for HA these effect sizes are stable during follow-up at 6, 12 and 26 weeks (1.60 (±0.04), 1.82 (±0.04) and 1.68 (±0.23), respectively) [Figure 3].


Intra-articular infiltration therapy for patients with glenohumeral osteoarthritis: A systematic review of the literature.

Colen S, Geervliet P, Haverkamp D, Van Den Bekerom MP - Int J Shoulder Surg (2014)

Pooled effect sizes and standard deviations placebo
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4262866&req=5

Figure 3: Pooled effect sizes and standard deviations placebo
Mentions: From the studies of Blaine et al.[14] and Kwon et al.[10] an effect size for placebo could be calculated. As for HA these effect sizes are stable during follow-up at 6, 12 and 26 weeks (1.60 (±0.04), 1.82 (±0.04) and 1.68 (±0.23), respectively) [Figure 3].

Bottom Line: Placebo (1.60, 1.82 and 1.68) also showed stable effect sizes at the same time points.Although statistical significant, the maximum difference in effect sizes between HA and placebo was only 0.43 with absolute values between 2.0 and 6.4 on a 100-point visual analogue score for pain.IA treatment with HA has a good efficacy at follow-up compared to baseline.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, University Hospitals Leuven, Pellenberg, Belgium ; Department of Orthopaedic Surgery and Traumatology, Hümmling Hospital Sögel, Sögel, Germany.

ABSTRACT

Background: Conservative treatments are especially in patients with glenohumeral osteoarthritis (GH-OA) important, since shoulder arthroplasty has its limitations. In this systematic review, we will evaluate the current evidence regarding the efficacy of intra-articular (IA) infiltration treatment options in patients with GH-OA.

Materials and methods: The following databases are searched: Pubmed/Medline, Cochrane Clinical Trial Register, Embase and the WHO clinical trial register. All IA injection products used for the treatment of shoulder OA in humans are included.

Results: A total of 8 studies could be included in this review. Hyaluronic acid (HA) showed effect sizes of 2.07, 2.02 and 2.11 at 6, 12 and 26 weeks follow-up, respectively. Placebo (1.60, 1.82 and 1.68) also showed stable effect sizes at the same time points. The efficacy of corticosteroids (CS) decreased rapidly at follow-up (1.08, 0.43 and 0.19). Although statistical significant, the maximum difference in effect sizes between HA and placebo was only 0.43 with absolute values between 2.0 and 6.4 on a 100-point visual analogue score for pain.

Conclusion: IA treatment with HA has a good efficacy at follow-up compared to baseline. However, the difference in efficacy between HA and placebo never reaches the minimal clinically important difference at any of the follow-up points. We are not able to give clear recommendations for the use of IA CS injections in patients with GH-OA. In future research, we recommend focusing on sufficiently powered randomized trials to compare the efficacies of HA, CS, placebo and other IA treatment options in patients with GH-OA.

No MeSH data available.


Related in: MedlinePlus