Department of Rehabilitation Medicine, Konkuk University Medical Center, Seoul, Republic of Korea.
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Republic of Korea.
Pain Physician. 2024 Sep;27(7):387-400.
Adhesive capsulitis of the shoulder causes inflammation and adhesions in the shoulder joint capsule, leading to pain and limited range of motion (ROM). Intraarticular corticosteroid (CS) and hyaluronic acid (HA) injections are common therapeutic options for adhesive capsulitis, but their comparative effectiveness remains unclear.
To provide a robust comparison of the outcomes of HA and CS, we conducted a meta-analysis of relevant previous studies that examined the therapeutic effects of intraarticular HA and CS injections in patients with adhesive capsulitis.
Systematic review and meta-analysis.
This meta-analysis of randomized controlled trials compared the effectiveness of intraarticular HA and CS injections. Of the 10,205 articles, 7 met our predetermined criteria and were included in the analysis.
Patients who received CS injections demonstrated superior pain reduction and functional improvement at 2-4 weeks after injection to those who received HA injections. Nevertheless, comparable outcomes were observed between the 2 groups at 6 and 12 weeks. The active or passive range of motion of the shoulder joint was not significantly different between patients who received HA injections and those who received CS injections.
The meta-analysis included only a small number of studies, and the number of HA injections examined in those studies varied from one to 3 at a time, whereas an CS injection was performed only once in most of the included studies.
The administration of intraarticular HA injection emerges as a commendable therapeutic option for patients with adhesive capsulitis, particularly for those requiring repetitive injections or at risk of developing side effects from injections of CS. Although intraarticular CS injections offer accelerated short-term (2-4 weeks) pain relief and functional improvement, comparable effects were observed within 6 and 12 weeks after intraarticular HA and CS injections.
肩粘连性囊炎会导致肩关节囊发炎和粘连，从而引起疼痛和活动范围受限。关节内皮质类固醇（CS）和透明质酸（HA）注射是治疗粘连性囊炎的常见选择，但它们的相对疗效仍不清楚。
为了提供 HA 和 CS 治疗效果的有力比较，我们对之前研究关节内 HA 和 CS 注射治疗粘连性囊炎的相关研究进行了荟萃分析。
系统回顾和荟萃分析。
这项随机对照试验的荟萃分析比较了关节内 HA 和 CS 注射的疗效。在 10205 篇文章中，有 7 篇符合我们预先设定的标准，并被纳入分析。
接受 CS 注射的患者在注射后 2-4 周时疼痛减轻和功能改善优于接受 HA 注射的患者。然而，两组在 6 周和 12 周时的结果相似。接受 HA 注射和 CS 注射的患者的肩关节主动或被动活动范围没有显著差异。
荟萃分析仅包括少数研究，而且这些研究中每次检查的 HA 注射次数从 1 次到 3 次不等，而大多数纳入的研究中仅进行了一次 CS 注射。
关节内 HA 注射是粘连性囊炎患者的一种值得称赞的治疗选择，特别是对于需要重复注射或有 CS 注射副作用风险的患者。尽管关节内 CS 注射在短期（2-4 周）内提供了更快的疼痛缓解和功能改善，但在关节内 HA 和 CS 注射后 6 周和 12 周内观察到了相似的效果。
