OBJECTIVE: To compare the efficacy of intra-articular hyaluronic acid (HA) injections plus physical therapy (PT) with that of PT alone for the treatment of adhesive capsulitis (AC) of the shoulder. DESIGN: Prospective, randomized controlled trial. SETTING:Rehabilitation and orthopedics department of a private teaching hospital. PARTICIPANTS: Patients (N=70) with AC of the shoulder were randomly placed into either of the following treatment groups: group 1, HA injections with PT (HAPT group); or group 2, PT alone (PT group). INTERVENTIONS: The patients in group 1 received intra-articular glenohumeral joint injections of HA, 20mg, once per week for 3 consecutive weeks and also participated in a PT program for 3 months. The patients in group 2 received PT alone. MAIN OUTCOME MEASURES: Active and passive range of motion (ROM) of the affected shoulder, pain, disability, and quality of life. RESULTS: Both groups experienced improvements in terms of pain, disability, and quality of life after the treatments; furthermore, the active and passive ROM improved linearly with increasing treatment duration. When the groups were compared, no significant group effect was found for any of the outcome measurements. CONCLUSIONS: Intra-articular HA injections did not produce added benefits for patients with AC of the shoulder who were already receiving PT. Thus, the use of intra-articular HA injections for patients with AC of the shoulder should be carefully assessed to reduce unnecessary medical expenditures.
RCT Entities:
OBJECTIVE: To compare the efficacy of intra-articularhyaluronic acid (HA) injections plus physical therapy (PT) with that of PT alone for the treatment of adhesive capsulitis (AC) of the shoulder. DESIGN: Prospective, randomized controlled trial. SETTING: Rehabilitation and orthopedics department of a private teaching hospital. PARTICIPANTS: Patients (N=70) with AC of the shoulder were randomly placed into either of the following treatment groups: group 1, HA injections with PT (HAPT group); or group 2, PT alone (PT group). INTERVENTIONS: The patients in group 1 received intra-articular glenohumeral joint injections of HA, 20mg, once per week for 3 consecutive weeks and also participated in a PT program for 3 months. The patients in group 2 received PT alone. MAIN OUTCOME MEASURES: Active and passive range of motion (ROM) of the affected shoulder, pain, disability, and quality of life. RESULTS: Both groups experienced improvements in terms of pain, disability, and quality of life after the treatments; furthermore, the active and passive ROM improved linearly with increasing treatment duration. When the groups were compared, no significant group effect was found for any of the outcome measurements. CONCLUSIONS:Intra-articularHA injections did not produce added benefits for patients with AC of the shoulder who were already receiving PT. Thus, the use of intra-articularHA injections for patients with AC of the shoulder should be carefully assessed to reduce unnecessary medical expenditures.