Clinical evaluation of high-molecular-weight sodium hyaluronate for the treatment of patients with periarthritis of the shoulder.

The clinical efficacy and tolerability of sodium hyaluronate, a high-molecular-weight hyaluronic acid preparation, in the treatment of patients with periarthritis of the shoulder was investigated in a multicenter, cooperative study. Of 70 patients seen at 12 participating centers between April and September 1992, follow-up was possible in 62 (28 men and 34 women; mean age, 65.4 years). Patients received sodium hyaluronate 25 mg (1% solution in an ampule) once weekly for 5 weeks by injection into the glenoid cavity or the subacromial bursa. If periarthritis resolved during this period, treatment was stopped; if periarthritis had not fully resolved by the end of the 5 weeks, weekly or biweekly treatment was continued as appropriate. The mean treatment period was 8.16 +/- 0.88 weeks, and the mean total administered dose was 6.05 +/- 0.61 ampules. Rates of improvement over pretreatment values were 75.0% for pain at rest, 73.7% for pain on motion, and 78.8% for pain on pressure. Significant increases in joint angles (measured as components of joint range of motion after administration of sodium hyaluronate) were observed; activities of daily living also improved significantly (P < 0.05 to P < 0.001). No adverse reactions were observed. These results strongly suggest that sodium hyaluronate is an effective agent for the treatment of patients with periarthritis of the shoulder.