Clinical evaluation of sodium hyaluronate for the treatment of patients with rotator cuff tear

Hyaluronic acid inhibits mRNA expression of proinflammatory cytokines and cyclooxygenase‐2/prostaglandin E2 production via CD44 in interleukin‐1‐stimulated subacromial synovial fibroblasts from patients with rotator cuff disease

“…In fact, in the English literature, only Shibata et al have reported the effectiveness of HA for treatment of rotator cuff disease. 15 Our study demonstrated an anti-inflammatory effect of HA in IL-1-stimulated SSF from patients with rotator cuff disease, which involved down-regulation of proinflammatory cytokine mRNAs and COX-2/PGE 2 production. Thus, our results provide a basis for explaining why HA is effective for the treatment of rotator cuff disease, and support its clinical utility.…”

“…29 In clinical practice, however, intraarticular HA injection is well tolerated, and no adverse effects have been reported in most previous studies. [12][13][14][15][30][31][32] Different sets of experiments will be required to confirm our data and verify our working hypothesis.…”

“…11 Intraarticular HA injection is used to treat knee OA, and its therapeutic efficacy has been verified. [12][13][14] In rotator cuff disease, Shibata et al uniquely demonstrated that HA injection is an effective conservative procedure, 15 although the mechanism of its anti-inflammatory effect is not fully understood.…”

Therapeutic effects of hyaluronate injections in patients with chronic painful shoulder: A meta‐analysis of randomized controlled trials

“…The studies were distributed within the 95% CI axis (intercept Ϫ0.69 [95% CI Ϫ8.06, 6.68]; P ϭ 0.39) as determined by Egger's regression method, indicating that there was no publication bias. For comparison of HA with steroid injections, 5 trials (252 participants) were found: 1 trial compared HA plus triamcinolone acetate versus triamcinolone (10), 2 trials compared HA versus triamcinolone acetate (11,36), and 2 trials compared HA versus dexamethasone (32,34). The SMD for the change in intensity of functional scores with HA versus steroid injection was 0.39 (95% CI 0.07, 0.71; P ϭ 0.02) (Figure 4), which indicates that HA had favorable efficacy compared with steroid injection.…”

Molecular effects of sodium hyaluronate on the healing of avian supracoracoid tendon tear: According to in situ hybridization and real‐time polymerase chain reaction

“…7 Postulated mechanisms of benefit mostly have focused on the viscosity of HA causing improvement of sliding properties or preventing adhesions. [2][3][4]6 Wiig and Abrahamsson 8 examined the effect of HA on cell proliferation and matrix production using rabbit deep flexor tendons, but the molecular pharmacology of HA in damaged rotator cuff tissues has not yet been investigated.…”