Lavigne Alexandre, Sandouk Edmond, Hiett Andrew, Chang Min Cheol, Bélanger Valérie, Lamontagne Martin, Khadavi Michael
Department of Physical Medicine and Rehabilitation, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
Shoulder Elbow. 2025 Mar 13:17585732251324484. doi: 10.1177/17585732251324484.
There is growing evidence that hyaluronic acid (HA) injections can significantly improve pain and function in rotator cuff tendinopathy. However, there is no consensus regarding the optimal parameters for HA injections. This narrative review explores the procedural considerations for HA injections in rotator cuff tendinopathy.
A literature search using Pubmed and Cochrane was conducted to assess procedural considerations for HA injections in rotator cuff tendinopathy including the type of HA (linear vs. cross-linked), the molecular weight (low, moderate, and high), the combination of HA with other products, the number and frequency of injections, the injection guidance, and the adverse effects.
Nine randomized-controlled trials and two prospective non-randomized studies assessed the efficacy of HA injections for rotator cuff tendinopathy, and their characteristics were thoroughly analyzed. Two studies compared the efficacy of different molecular weight HA. One study assessed the efficacy of HA combined with extracorporeal shockwave therapy.
Highlights of the findings include the clinical benefits of HA injections for rotator cuff tendinopathy, the better tolerability of low molecular weight HA compared to high molecular weight, the safer adverse effect profile of HA compared to glucocorticoid injections, and the synergistic effect of HA and extracorporeal shockwave therapy.
越来越多的证据表明，注射透明质酸（HA）可显著改善肩袖肌腱病的疼痛和功能。然而，关于HA注射的最佳参数尚无共识。本叙述性综述探讨了肩袖肌腱病HA注射的操作注意事项。
通过检索PubMed和Cochrane进行文献检索，以评估肩袖肌腱病HA注射的操作注意事项，包括HA的类型（线性与交联）、分子量（低、中、高）、HA与其他产品的联合使用、注射次数和频率、注射引导以及不良反应。
九项随机对照试验和两项前瞻性非随机研究评估了HA注射治疗肩袖肌腱病的疗效，并对其特征进行了全面分析。两项研究比较了不同分子量HA的疗效。一项研究评估了HA联合体外冲击波治疗的疗效。
研究结果的重点包括HA注射治疗肩袖肌腱病的临床益处、低分子量HA比高分子量HA具有更好的耐受性、与糖皮质激素注射相比，HA的不良反应谱更安全，以及HA与体外冲击波治疗的协同作用。
