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First published on March 29, 2007, doi:10.1177/0363546507300256
This version was published on June 1, 2007
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The American Journal of Sports Medicine 35:979-985 (2007)
© 2007 American Orthopaedic Society for Sports Medicine

The Use of Intra-articular Hylan G-F 20 in the Treatment of Symptomatic Osteoarthritis of the Shoulder

A Preliminary Study

Eric Silverstein, MD, Robin Leger, PhD and Kevin P. Shea, MD*

From the Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, Connecticut

* Address correspondence to Kevin P. Shea, MD, Medical Arts and Research Building, Suite N4019, 263 Farmington Avenue, Farmington, CT 06034-4037 (e-mail: shea{at}nso.uchc.edu).

Background: While hylan G-F 20 is an approved therapy for the treatment of knee osteoarthritis, there are few reports of its use in shoulder osteoarthritis.

Hypothesis: Hylan G-F 20 can reduce pain and improve function in patients with glenohumeral osteoarthritis.

Study Design: Case series; Level of evidence, 4.

Methods: Thirty consecutive patients with idiopathic glenohumeral osteoarthritis who failed to respond to standard conservative measures were enrolled. Patients received 3 weekly intra-articular hylan G-F 20 injections in their affected shoulder and completed a visual analog scale for pain, the UCLA score, and the Simple Shoulder Test at baseline and at 1, 3, and 6 months after the third injection.

Results: Of the 30 patients, 3 withdrew during the washout period before treatment; the remaining patients (17 men and 10 women) had an average age of 62 years. The mean baseline visual analog scale score was 54, UCLA score was 15.7, and Simple Shoulder Test score was 5.7 (of 12 possible "yes" responses). At the 6-month follow-up, hylan G-F 20 significantly improved visual analog scale (mean 30, P < .001), UCLA (mean 24, P < .001), and Simple Shoulder Test (7.6 "yes" responses, P < .001) scores. More patients slept comfortably after treatment (56%) versus before treatment (15%). Nine patients had a visual analog scale improvement >40 points after 6 months. No device-related adverse events were observed.

Conclusion: Hylan G-F 20 may have a beneficial therapeutic effect on some symptomatic patients with glenohumeral osteoarthritis.

Key Words: osteoarthritis • viscosupplementation • hylans • hyaluronic acid






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