Liu Weijun, Lin Bendan, Yao Hongbin, Chen Zhanpeng, Hu Yishan
First Department of Orthopedics, Shantou Central Hospital, Shantou, Guangdong Province, China.
Orthop J Sports Med. 2022 Aug 25;10(8):23259671221115743. doi: 10.1177/23259671221115743. eCollection 2022 Aug.
Rotator cuff pathology is a common cause of pain and shoulder dysfunction. Several nonoperative treatment modalities have been developed for rotator cuff lesions, but their relative efficacy is not well-established.
PURPOSE/HYPOTHESIS: The purpose of this systematic review and meta-analysis was to evaluate the efficacy and safety of sodium hyaluronate (SH) in the treatment of patients with rotator cuff lesions. It was hypothesized that SH would be found to be more effective than other nonoperative regimens.
Systematic review; Level of evidence, 3.
We searched various databases to identify eligible studies that evaluated the effects of SH on the pain and shoulder dysfunction attributed to rotator cuff lesions. Outcome measures were pain visual analog scale (VAS) score; Constant score; University of California, Los Angeles (UCLA) score; satisfaction rate; complications; and factors affecting the pain VAS score. Outcomes were reported as weighted mean difference (WMD) or risk ratio.
A total of 9 studies were identified for data analysis. Compared with patients treated with other nonoperative treatments (controls), those treated with SH had significantly improved pain VAS scores at 1 week (WMD = -0.95; 95% CI, -1.75 to -0.16; = .019), 2 weeks (WMD = -1.05; 95% CI, -2.07 to -0.03; = .044), 3 weeks (WMD = -1.49; 95% CI, -2.88 to -0.11; = .035), and 4 weeks (WMD = -2.12; 95% CI, -4.05 to -0.19; = .031). The Constant score was significantly improved in the SH group versus controls at 2 weeks (WMD = 3.25; 95% CI, 2.36 to 4.13; < .001), 3 months (WMD = 20.28; 95% CI, 0.54 to 40.03; = .044), and 6 months (WMD = 5.58; 95% CI, 0.94 to 10.21; = .018). The UCLA score and satisfaction rate did not differ significantly between the 2 groups. No complications associated with SH were reported in the included studies. Metaregression analysis showed that, except for study design (coefficient = -1.64; 95% CI, -2.64 to -0.63; = .002), none of the variables (sample size, tear type, control treatments) significantly predicted the difference in VAS pain score between SH and other treatments.
The present meta-analysis demonstrated that SH was effective in treating patients with rotator cuff lesions.
肩袖病变是疼痛和肩部功能障碍的常见原因。针对肩袖损伤已开发出多种非手术治疗方法，但其相对疗效尚未完全明确。
目的/假设：本系统评价和荟萃分析的目的是评估透明质酸钠（SH）治疗肩袖损伤患者的疗效和安全性。假设SH比其他非手术治疗方案更有效。
系统评价；证据等级，3级。
我们检索了多个数据库，以确定评估SH对肩袖损伤所致疼痛和肩部功能障碍影响的合格研究。结局指标包括疼痛视觉模拟量表（VAS）评分、Constant评分、加利福尼亚大学洛杉矶分校（UCLA）评分、满意率、并发症以及影响疼痛VAS评分的因素。结局以加权平均差（WMD）或风险比报告。
共纳入9项研究进行数据分析。与接受其他非手术治疗（对照组）的患者相比，接受SH治疗的患者在1周时疼痛VAS评分显著改善（WMD = -0.95；95%CI，-1.75至-0.16；P = 0.019），2周时（WMD = -1.05；95%CI，-2.07至-0.03；P = 0.044），3周时（WMD = -1.49；95%CI，-2.88至-0.11；P = 0.035），4周时（WMD = -2.12；95%CI，-4.05至-0.19；P = 0.031）。与对照组相比，SH组在2周时Constant评分显著改善（WMD = 3.25；95%CI，2.36至4.13；P < 0.001），3个月时（WMD = 20.28；95%CI，0.54至40.03；P = 0.044），6个月时（WMD = 5.58；95%CI，0.94至10.21；P = 0.018）。两组间UCLA评分和满意率无显著差异。纳入研究中未报告与SH相关的并发症。Meta回归分析显示，除研究设计外（系数 = -1.64；95%CI，-2.64至-0.63；P = 0.002），其他变量（样本量、撕裂类型、对照治疗）均未显著预测SH与其他治疗之间VAS疼痛评分的差异。
本荟萃分析表明，SH治疗肩袖损伤患者有效。
